1. The value of lactate dehydrogenase serum levels as a prognostic and predictive factor for advanced pancreatic cancer patients receiving sorafenib
- Author
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Michela Cinquini, Enrico Aitini, Daris Ferrari, F. Caprioni, Roberto Labianca, Stefania Mosconi, Luca Faloppi, Corrado Boni, Alessandro Bittoni, Mario Scartozzi, Stefano Cascinu, Alberto Zaniboni, Sandro Barni, Kalliopi Andrikou, Maristella Bianconi, Riccardo Giampieri, Alberto Sobrero, Silvia Fanello, Valter Torri, and Rossana Berardi
- Subjects
Adult ,Male ,Niacinamide ,Sorafenib ,medicine.medical_specialty ,Angiogenesis ,medicine.medical_treatment ,pancreatic cancer ,Antineoplastic Agents ,Kaplan-Meier Estimate ,Gastroenterology ,Disease-Free Survival ,angiogenesis ,chemistry.chemical_compound ,Pancreatic cancer ,Internal medicine ,Lactate dehydrogenase ,Biomarkers, Tumor ,medicine ,Humans ,Progression-free survival ,Aged ,Aged, 80 and over ,Chemotherapy ,L-Lactate Dehydrogenase ,business.industry ,Phenylurea Compounds ,lactate dehydrogenase ,Middle Aged ,Prognosis ,medicine.disease ,TKI ,Pancreatic Neoplasms ,Clinical trial ,Endocrinology ,Oncology ,chemistry ,Female ,Clinical Research Paper ,business ,Tyrosine kinase ,medicine.drug - 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.
- Published
- 2015
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