Baseline D-dimer as a predictor of immune checkpoint inhibitor efficacy in cancer.
Fan Li, Jie Zha, Meimei Hu et al.
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In 30 seconds
This systematic review and meta-analysis examined whether baseline D-dimer predicts outcomes in cancer patients receiving immune checkpoint inhibitors. It pooled evidence from 10 retrospective studies involving 1,217 patients. Elevated D-dimer was associated with worse overall survival (HR = 1.95, 95% CI: 1.62-2.36, p < 0.001) and shorter progression-free survival (HR = 2.03, 95% CI: 1.57-2.63, p < 0.001). Higher levels were also associated with lower response and disease control rates. The findings support D-dimer as a potential prognostic marker, while prospective validation remains necessary.
Key findings
- Elevated baseline D-dimer was associated with worse overall survival (HR = 1.95, 95% CI: 1.62-2.36, p < 0.001).
- Elevated baseline D-dimer was associated with shorter progression-free survival (HR = 2.03, 95% CI: 1.57-2.63, p < 0.001).
- Higher D-dimer correlated with lower objective response rate (OR = 0.42, 95% CI: 0.26-0.68, p < 0.001) and disease control rate (OR = 0.18, 95% CI: 0.10-0.34, p < 0.001).
Why it matters
D-dimer is readily measurable, and its association with survival and response outcomes suggests it may help characterize prognosis among patients receiving immune checkpoint inhibitors. However, these pooled associations do not establish that D-dimer predicts treatment benefit specifically or that using it to guide decisions improves outcomes. The findings therefore provide a rationale for further validation rather than a basis for changing treatment selection.
What to keep in mind
The evidence came from 10 retrospective studies; the authors state that prospective multicenter studies are needed to validate cutoff thresholds and define clinical utility.