Clinical Research Papers:
The value of lactate dehydrogenase serum levels as a prognostic and predictive factor for advanced pancreatic cancer patients receiving sorafenib
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Luca Faloppi1, Maristella Bianconi1, Riccardo Giampieri1, Alberto Sobrero2, Roberto Labianca3, Daris Ferrari4, Sandro Barni5, Enrico Aitini6, Alberto Zaniboni7, Corrado Boni8, Francesco Caprioni2, Stefania Mosconi3, Silvia Fanello8, Rossana Berardi1, Alessandro Bittoni1, Kalliopi Andrikou1, Michela Cinquini9, Valter Torri9, Mario Scartozzi10, Stefano Cascinu1, on behalf of the Italian Group for the Study of Digestive Tract Cancer (GISCAD)
1Medical Oncology Unit, Università Politecnica delle Marche, AOU “Ospedali Riuniti”, Ancona, Italy
2Medical Oncology Unit, Ospedale S. Martino, Genova, Italy
3Medical Oncology Unit, Ospedali Riuniti, Bergamo, Italy
4Medical Oncology Unit, Ospedale S. Paolo, Milano, Italy
5Medical Oncology Unit, Treviglio Hospital, Treviglio, Italy
6Medical Oncology Unit, C. Poma Hospital, Mantova, Italy
7Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy
8Medical Oncology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
9New Drug Development Strategies Laboratory, Mario Negri Institute, Milano, Italy
10Medical Oncology Unit, Università degli Studi di Cagliari, Azienda Ospedaliero Universitaria, Cagliari, Italy
Stefano Cascinu, e-mail: [email protected]
Keywords: pancreatic cancer, lactate dehydrogenase, angiogenesis, sorafenib, TKI
Received: May 22, 2015 Accepted: August 28, 2015 Published: September 10, 2015
Although lactate dehydrogenase (LDH) serum levels, indirect markers of angiogenesis, are associated with a worse outcome in several tumours, their prognostic value is not defined in pancreatic cancer. Moreover, high levels are associated even with a lack of efficacy of tyrosine kinase inhibitors, contributing to explain negative results in clinical trials. We assessed the role of LDH in advanced pancreatic cancer receiving sorafenib.
Seventy-one of 114 patients included in the randomised phase II trial MAPS (chemotherapy plus or not sorafenib) and with available serum LDH levels, were included in this analysis. Patients were categorized according to serum LDH levels (LDH ≤vs.> upper normal rate).
A significant difference was found in progression free survival (PFS) and in overall survival (OS) between patients with LDH values under or above the cut-off (PFS: 5.2 vs. 2.7 months, p = 0.0287; OS: 10.7 vs. 5.9 months, p = 0.0021).
After stratification according to LDH serum levels and sorafenib treatment, patients with low LDH serum levels treated with sorafenib showed an advantage in PFS (p = 0.05) and OS (p = 0.0012).
LDH appears to be a reliable parameter to assess the prognosis of advanced pancreatic cancer patients, and it may be a predictive parameter to select patients candidate to receive sorafenib.
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