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Posted by on May 16, 2017 in Melanoma | 0 comments

In a nutshell

This study investigated whether changes in lactate dehydrogenase (LDH) levels in the blood could predict treatment response to PD-1 agents. Researchers suggested that LDH could be a useful factor to predict treatment outcomes in patients with advanced melanoma.  

Some background

The use of PD-1 agents to treat melanoma is rapidly increasing. These treatments stimulate the immune system to attack cancer cells by blocking the PD-1 receptor. Recent studies have suggested that PD-1 agents are more active in treating advanced melanoma than chemotherapy alone.

Blood levels of LDH are a prognostic factor for survival and part of the staging decision for stage 4 melanoma. However, whether LDH level is predictive of PD-1 treatment response and outcomes is unclear.  

Methods & findings

The objective of this study was to determine if blood levels of LDH is a reliable predictive factor to predict the response to treatment with a PD-1 agent.

This study included 66 patients with advanced melanoma treated with either pembrolizumab (Keytruda) or nivolumab (Opdivo). Blood levels of LDH were measured within 3 days before treatment. 51.5% of patients had an elevated LDH at the treatment start.

Patients with elevated LDH had a shorter 12 month overall survival (44.2%) when compared to patients with normal levels of LDH (71.5%). Among the patients with elevated LDH levels, the LDH change during the treatment was associated with treatment response. Patients with partial response (32%) had a 27.3% reduction in LDH levels. In contrast, patients with progressive cancer had an increase of 39% in LDH levels. Patients with an increase of over 10% of LDH had a shorter OS (4.3 months) when compared to patients with a less than 10% change (15.7 months).  

The bottom line

This study showed that an increasing LDH during the first weeks of treatment with PD-1 agents can predict melanoma progression and is associated with a decreased survival.

Published By :

British Journal of Cancer

Date :

Jan 21, 2016

Original Title :

Serum lactate dehydrogenase as an early marker for outcome in patients treated with anti-PD-1 therapy in metastatic melanoma.

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