title: The value of lactate dehydrogenase serum levels as a prognostic and predictive factor for advanced pancreatic cancer patients receiving sorafenib.
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.
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Faloppi
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Maristella
authors.initials: M
authors.lastname: Bianconi
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Giampieri
authors.affiliation: Medical Oncology Unit, Ospedale S. Martino, Genova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Sobrero
authors.affiliation: Medical Oncology Unit, Ospedali Riuniti, Bergamo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Labianca
authors.affiliation: Medical Oncology Unit, Ospedale S. Paolo, Milano, Italy.
authors.forename: Daris
authors.initials: D
authors.lastname: Ferrari
authors.affiliation: Medical Oncology Unit, Treviglio Hospital, Treviglio, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.affiliation: Medical Oncology Unit, C. Poma Hospital, Mantova, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Aitini
authors.affiliation: Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zaniboni
authors.affiliation: Medical Oncology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Boni
authors.affiliation: Medical Oncology Unit, Ospedale S. Martino, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Caprioni
authors.affiliation: Medical Oncology Unit, Ospedali Riuniti, Bergamo, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Mosconi
authors.affiliation: Medical Oncology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fanello
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bittoni
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Andrikou
authors.affiliation: New Drug Development Strategies Laboratory, Mario Negri Institute, Milano, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Cinquini
authors.affiliation: New Drug Development Strategies Laboratory, Mario Negri Institute, Milano, Italy.
authors.forename: Valter
authors.initials: V
authors.lastname: Torri
authors.affiliation: Medical Oncology Unit, Università degli Studi di Cagliari, Azienda Ospedaliero Universitaria, Cagliari, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Scartozzi
authors.affiliation: Medical Oncology Unit, Università Politecnica delle Marche, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011379:Prognosis; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib; D007770:L-Lactate Dehydrogenase
keywords: TKI; angiogenesis; lactate dehydrogenase; pancreatic cancer; sorafenib