Abstract
BACKGROUND: Different antiangiogenics are currently indicated in the second-line treatment of metastatic colorectal cancer (mCRC), following a first-line bevacizumab-containing treatment. The magnitude of benefit is limited, but no predictors of benefit have been identified.METHODS: A total of 184 mCRC patients progressing to a first-line bevacizumab-containing treatment were randomised in the BEBYP study to continue or not the antiangiogenic in combination with a second-line chemotherapy. A subgroup analysis according to baseline serum lactate dehydrogenase (LDH) levels was carried out.RESULTS: A significant interaction effect between LDH levels and treatment was found in terms of progression-free survival (PFS; P=0.002). Although patients with low LDH levels achieved significant PFS benefit from the continuation of bevacizumab (HR: 0.39 (95% CI: 0.23-0.65)), patients with high levels did not (HR: 1.10 (95% CI: 0.74-1.64)). Consistent results were reported in overall survival (OS; P=0.075).CONCLUSIONS: As preclinical evidence suggests that serum LDH may be a marker of tumour angiogenesis activation, low levels may indicate that bevacizumab is still efficacious in inhibiting angiogenesis. Validation of present results in subgroup analyses of other randomised trials of second-line angiogenesis inhibitors is warranted.
Original language | English |
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Pages (from-to) | 318-323 |
Number of pages | 6 |
Journal | British Journal of Cancer |
Volume | 116 |
Issue number | 3 |
DOIs | |
Publication status | Published - Jan 2017 |
Keywords
- Adenocarcinoma
- Adult
- Aged
- Angiogenesis Inhibitors
- Bevacizumab
- Biomarkers, Tumor
- Chemotherapy, Adjuvant
- Colorectal Neoplasms
- Disease Progression
- Female
- Humans
- L-Lactate Dehydrogenase
- Male
- Middle Aged
- Neoplasm Metastasis
- Prognosis
- Treatment Outcome
- Clinical Trial, Phase III
- Journal Article
- Multicenter Study
- Randomized Controlled Trial
- Research Support, Non-U.S. Gov't