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Oncotarget. 2015 Oct 27;6(33):35087-94. doi: 10.18632/oncotarget.5197.

The value of lactate dehydrogenase serum levels as a prognostic and predictive factor for advanced pancreatic cancer patients receiving sorafenib.

Author information

1
Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
2
Medical Oncology Unit, Ospedale S. Martino, Genova, Italy.
3
Medical Oncology Unit, Ospedali Riuniti, Bergamo, Italy.
4
Medical Oncology Unit, Ospedale S. Paolo, Milano, Italy.
5
Medical Oncology Unit, Treviglio Hospital, Treviglio, Italy.
6
Medical Oncology Unit, C. Poma Hospital, Mantova, Italy.
7
Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.
8
Medical Oncology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy.
9
New Drug Development Strategies Laboratory, Mario Negri Institute, Milano, Italy.
10
Medical Oncology Unit, Università degli Studi di Cagliari, Azienda Ospedaliero Universitaria, Cagliari, Italy.

Abstract

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.

KEYWORDS:

TKI; angiogenesis; lactate dehydrogenase; pancreatic cancer; sorafenib

PMID:
26397228
PMCID:
PMC4741511
DOI:
10.18632/oncotarget.5197
[Indexed for MEDLINE]
Free PMC Article

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