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Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer

BACKGROUND: To investigate the impact of pre-treatment lactate dehydrogenase (LDH) levels on the outcome of patients with metastatic colorectal cancer treated with first-line chemotherapy with or without the anti-VEGF monoclonal antibody, bevacizumab, in a phase III prospective multicentre randomize...

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Autores principales: Passardi, Alessandro, Scarpi, Emanuela, Tamberi, Stefano, Cavanna, Luigi, Tassinari, Davide, Fontana, Annalisa, Pini, Sara, Bernardini, Ilaria, Accettura, Caterina, Ulivi, Paola, Frassineti, Giovanni Luca, Amadori, Dino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526665/
https://www.ncbi.nlm.nih.gov/pubmed/26244985
http://dx.doi.org/10.1371/journal.pone.0134732
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author Passardi, Alessandro
Scarpi, Emanuela
Tamberi, Stefano
Cavanna, Luigi
Tassinari, Davide
Fontana, Annalisa
Pini, Sara
Bernardini, Ilaria
Accettura, Caterina
Ulivi, Paola
Frassineti, Giovanni Luca
Amadori, Dino
author_facet Passardi, Alessandro
Scarpi, Emanuela
Tamberi, Stefano
Cavanna, Luigi
Tassinari, Davide
Fontana, Annalisa
Pini, Sara
Bernardini, Ilaria
Accettura, Caterina
Ulivi, Paola
Frassineti, Giovanni Luca
Amadori, Dino
author_sort Passardi, Alessandro
collection PubMed
description BACKGROUND: To investigate the impact of pre-treatment lactate dehydrogenase (LDH) levels on the outcome of patients with metastatic colorectal cancer treated with first-line chemotherapy with or without the anti-VEGF monoclonal antibody, bevacizumab, in a phase III prospective multicentre randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial. METHODS: Three hundred and seventy patients enrolled onto the ITACa first-line trial were considered for this study, 176 receiving chemotherapy (either FOLFIRI or FOLFOX) plus bevacizumab and 194 receiving chemotherapy only. Pre-treatment LDH levels were evaluated to identify a potential correlation with progression-free survival (PFS), overall survival (OS) and objective response rate. RESULTS: Information on pre-treatment LDH levels was available for 344 patients. High LDH levels were predictive of a lower median PFS (8.1 months vs. 9.2 months, p< 0.0001) and median OS (16.1 months vs. 25.2 months, p< 0.0001) in the overall population. In the chemotherapy plus bevacizumab group, median PFS was 9.1 and 9.8 months in patients with high LDH and low LDH, respectively (p= 0.073), whereas in the chemotherapy-only arm it was 6.9 and 9.1 months, respectively (p < 0.0001). In patients with high LDH, the addition of bevacizumab to chemotherapy led to a reduction in the rate of progressive disease (16.4 vs. 30.5%, p= 0.081) and to a prolonged PFS (p= 0.028). CONCLUSION: A high LDH value was confirmed as a marker of poor prognosis. Bevacizumab reduced the progressive disease rate and improved PFS in the high-LDH subgroup, making serum LDH a potentially effective an easily available and marker to select patients who benefit from bevacizumab. TRIAL REGISTRATION: NCT01878422 ClinicalTrials.gov
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spelling pubmed-45266652015-08-12 Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer Passardi, Alessandro Scarpi, Emanuela Tamberi, Stefano Cavanna, Luigi Tassinari, Davide Fontana, Annalisa Pini, Sara Bernardini, Ilaria Accettura, Caterina Ulivi, Paola Frassineti, Giovanni Luca Amadori, Dino PLoS One Research Article BACKGROUND: To investigate the impact of pre-treatment lactate dehydrogenase (LDH) levels on the outcome of patients with metastatic colorectal cancer treated with first-line chemotherapy with or without the anti-VEGF monoclonal antibody, bevacizumab, in a phase III prospective multicentre randomized ITACa (Italian Trial in Advanced Colorectal Cancer) trial. METHODS: Three hundred and seventy patients enrolled onto the ITACa first-line trial were considered for this study, 176 receiving chemotherapy (either FOLFIRI or FOLFOX) plus bevacizumab and 194 receiving chemotherapy only. Pre-treatment LDH levels were evaluated to identify a potential correlation with progression-free survival (PFS), overall survival (OS) and objective response rate. RESULTS: Information on pre-treatment LDH levels was available for 344 patients. High LDH levels were predictive of a lower median PFS (8.1 months vs. 9.2 months, p< 0.0001) and median OS (16.1 months vs. 25.2 months, p< 0.0001) in the overall population. In the chemotherapy plus bevacizumab group, median PFS was 9.1 and 9.8 months in patients with high LDH and low LDH, respectively (p= 0.073), whereas in the chemotherapy-only arm it was 6.9 and 9.1 months, respectively (p < 0.0001). In patients with high LDH, the addition of bevacizumab to chemotherapy led to a reduction in the rate of progressive disease (16.4 vs. 30.5%, p= 0.081) and to a prolonged PFS (p= 0.028). CONCLUSION: A high LDH value was confirmed as a marker of poor prognosis. Bevacizumab reduced the progressive disease rate and improved PFS in the high-LDH subgroup, making serum LDH a potentially effective an easily available and marker to select patients who benefit from bevacizumab. TRIAL REGISTRATION: NCT01878422 ClinicalTrials.gov Public Library of Science 2015-08-05 /pmc/articles/PMC4526665/ /pubmed/26244985 http://dx.doi.org/10.1371/journal.pone.0134732 Text en © 2015 Passardi et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Passardi, Alessandro
Scarpi, Emanuela
Tamberi, Stefano
Cavanna, Luigi
Tassinari, Davide
Fontana, Annalisa
Pini, Sara
Bernardini, Ilaria
Accettura, Caterina
Ulivi, Paola
Frassineti, Giovanni Luca
Amadori, Dino
Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer
title Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer
title_full Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer
title_fullStr Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer
title_full_unstemmed Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer
title_short Impact of Pre-Treatment Lactate Dehydrogenase Levels on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer
title_sort impact of pre-treatment lactate dehydrogenase levels on prognosis and bevacizumab efficacy in patients with metastatic colorectal cancer
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526665/
https://www.ncbi.nlm.nih.gov/pubmed/26244985
http://dx.doi.org/10.1371/journal.pone.0134732
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