CTLA4 and melanoma: Wagner et al observed that LDH might be an independent prognostic factor for response to anti-PD-1 or combined anti-PD-1 plus anti-CTLA-4 antibodies therapy and OS of melanoma patients.[25] Moreover, Kelderman et al found that for melanoma patients whose serum LDH level is more significant than twice the upper limit of normal, long-term treatment with ipilimumab may not benefit.[26] To conclude, LDH has certain predictive value for the treatment and prognosis of patients with malignant melanoma.