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

Luca Faloppi, Maristella Bianconi, Riccardo Giampieri, Alberto Sobrero, Roberto Labianca, Daris Ferrari, Sandro Barni, Enrico Aitini, Alberto Zaniboni, Corrado Boni, Francesco Caprioni, Stefania Mosconi, Silvia Fanello, Rossana Berardi, Alessandro Bittoni, Kalliopi Andrikou, Michela Cinquini, Valter Torri, Mario Scartozzi, Stefano Cascinu

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)35087-35094
Number of pages8
JournalOncotarget
Volume6
Issue number33
DOIs
Publication statusPublished - 2015

Keywords

  • Angiogenesis
  • Lactate dehydrogenase
  • Pancreatic cancer
  • Sorafenib
  • TKI

ASJC Scopus subject areas

  • Oncology

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