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Serum LDH predicts benefit from bevacizumab beyond progression in metastatic colorectal cancer
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Serum LDH predicts benefit from bevacizumab beyond progression in metastatic colorectal cancer
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Journal Article
Serum LDH predicts benefit from bevacizumab beyond progression in metastatic colorectal cancer
2017
Overview
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.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
