The correlation between LDH serum levels and clinical outcome in advanced biliary tract cancer patients treated with first line chemotherapy

Abstract

LDH may represent an indirect marker of neo-angiogenesis and worse prognosis in many tumour types. We assessed the correlation between LDH and clinical outcome for biliary tract cancer (BTC) patients treated with first-line chemotherapy. Overall, 114 advanced BTC patients treated with first-line gemcitabine and cisplatin were included. Patients were divided into two groups (low vs. high LDH), according to pre-treatment LDH values. Patients were also classified according to pre- and post-treatment variation in LDH serum levels (increased vs. decreased). Median progression free survival (PFS) was 5.0 and 2.6 months respectively in patients with low and high pre-treatment LDH levels (p = 0.0042, HR = 0.56, 95% CI: 0.37–0.87). Median overall survival (OS) was 7.7 and 5.6 months (low vs. high LDH) (p = 0.324, HR = 0.81, 95% CI: 0.54–1.24). DCR was 71% vs. 43% (low vs. high LDH) (p = 0.002). In 38 patients with decreased LDH values after treatment, PFS and OS were respectively 6.2 and 12.1 months, whereas in 76 patients with post-treatment increased LDH levels, PFS and OS were respectively 3.0 and 5.1 months (PFS: p = 0.0009; HR = 0.49; 95% IC: 0.33–0.74; OS: p < 0.0001; HR = 0.42; 95% IC: 0.27–0.63). Our data seem to suggest that LDH serum level may predict clinical outcome in BTC patients receiving first-line chemotherapy.

Pre‐treatment serum lactate dehydrogenase as a biomarker in small cell lung cancer

“…MOS in another study was quoted to be 8.7 months among LS‐SCLC patients with high s‐LDH compared to the 12 months MOS reported among patients with normal s‐LDH . Similarly, among patients with ES‐SCLC or other advanced cancers like biliary tract cancers, high s‐LDH remained a clinically significant negative prognosticator; progression‐free survival and MOS were both observed to be reduced among high s‐LDH patients at 2.6 versus 5.0 months and 5.6 versus 7.7 months, respectively . The survival data from these studies closely resembled the survival data observed in our study.…”

Prognostic Factors for Survival in Patients with Advanced Intrahepatic Cholangiocarcinoma Treated with Gemcitabine plus Cisplatin as First-Line Treatment

“…It has been in fact demonstrated that high LDH serum levels were associated with tumor overexpression of VEGFA and VEGF receptors in many tumor types. It has been postulated that LDH levels may represent an indirect marker of activated tumor angiogenesis and a worse prognosis [24].…”

The interplay of circulating tumor DNA and chromatin modification, therapeutic resistance, and metastasis

“…Serum LDH is also a possible marker for metastasis, prediction of therapeutic efficacy and prognosis. [148][149][150][151] Studies on melanoma have demonstrated that ctDNA has a higher sensitivity than LDH to detect disease progression and treatment response, making it a more promising blood-based biomarker than LDH. [152,153] Mitochondria provide energy for cell functioning and contain their own genetic material, mitochondrial DNA (mtDNA), which encodes 13 proteins of the mitochondrial proteome.…”