In a nutshell
This study examined the most accurate predictor of survival in patients with metastatic melanoma being treated with bevacizumab (Avastin).
Some background
Since melanomas are highly dependent on the formation of new blood vessels, bevacizumab (Avastin), a drug which blocks new blood vessel formation, is often used in their treatment. However, for reasons that are not yet fully understood, responses to treatment and survival rates vary. This makes accurately predicting survival and treatment benefit very difficult.
Lactate dehydrogenase (LDH), a protein released into the blood when cells are damaged, has been reported to predict response to treatment in several trials. Imaging scans, such as computer tomography (CT), may also provide valuable information regarding the effectiveness of treatment by assessing changes in tumor size, appearance and structure (referred to as MASS criteria). The current study examined whether CT scans combined with LDH blood levels could serve as an accurate predictor of survival in metastatic melanoma patients.
Methods & findings
118 metastatic melanoma lesions in 44 patients who were receiving bevacizumab were examined by CT scans during and after treatments. Data regarding LDH levels at the beginning and end of treatments was also available. Patients were followed for an average of two years following treatment.
High levels of LDH were found to be associated with disease progression and overall survival. Every 100 IU/L increase in LDH was associated with a 29% increase in the risk of disease progression despite treatment, and a 44% increase in the risk of decreased survival. When combining scores from CT scans (according to the MASS criteria) and LDH measurements, researchers estimated progression within 9 months and survival at 18 months could be predicted with 97% accuracy.
The bottom line
Researchers concluded that for patients treated with bevacizumab, the most accurate predictor of both disease progression and overall survival is a combination of LDH measurements and imaging based MASS criteria scores.
The fine print
This study included only few patients, resulting in the risk of biased results.
Published By :
Radiology
Date :
Sep 26, 2013
