AI Article Synopsis
- Previous research indicated that high levels of lactic dehydrogenase (LDH) in colorectal cancer patients may enhance the effectiveness of bevacizumab treatment.
- A phase II trial with 81 patients aimed to examine the effects of combining bevacizumab with FOLFIRI on response rates, overall survival, and progression-free survival based on LDH levels.
- The trial results showed no significant difference in response rates or progression-free survival between patients with high and low LDH levels, although those with low LDH had better overall survival, leading to the conclusion that LDH levels should not be considered a predictive factor for treatment effectiveness in this context.
Article Abstract
Background: Previous findings suggested that bevacizumab might be able to improve response rate (RR) in colorectal cancer patients with high lactic dehydrogenase (LDH) basal levels.
Methods: We conducted a phase II trial to prospectively ascertain whether bevacizumab in combination with FOLFIRI could have an improved clinical activity in patients with high LDH serum levels. Primary end point of the study was RR; secondary end points were median overall survival and median progression-free survival (mPFS).
Results: A total of 81 patients were enrolled. No difference in terms of ORR (39% vs 31% for low vs high LDH level stratum, P=0.78) and mPFS (14.16 vs 10.29 months, HR: 1.07, 95% CI: 0.51-2.24, P=0.83) between the strata was observed, whereas overall survival (OS) was significantly longer for patients with low LDH (24.85 vs 15.14 months, HR: 4.08, 95% CI: 1.14-14.61, P=0.0004). In a not-pre-planned exploratory analysis using different cut-off ranges for LDH, we observed RR up to 70%, with no improvement in progression-free survival or OS.
Conclusions: The CENTRAL trial failed to demonstrate that high LDH levels were related to a significantly improved RR in patients receiving first-line FOLFIRI and bevacizumab. The LDH serum levels should then no further be investigated as a predictive factor in this setting.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674092 | PMC |
| http://dx.doi.org/10.1038/bjc.2017.234 | DOI Listing |
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