Thématique :
- Cancer colorectal
Originalité :
Solidité :
A confirmer
Doit faire évoluer notre pratique :
Pas encore
Nom du veilleur :
Professeur Sylvain MANFREDI
Coup de coeur :
British journal of Cancer
  318-323. 2017 Jan  
  DOI: 10.1038/bjc.2016.413  
  Serum LDH predicts benefit from bevacizumab beyond progression in metastatic colorectal cancer  
  Federica Marmorino, Lisa Salvatore, Cecilia Barbara, Giacomo Allegrini, Lorenzo Antonuzzo, Gianluca Masi, Fotios Loupakis, Beatrice Borelli, Silvana Chiara, Maria Chiara Banzi, Emanuela Miraglio, Domenico Amoroso, Francesco Dargenio, Andrea Bonetti, Angelo Martignetti, Myriam Paris, Daniela Tomcikova, Luca Boni, Alfredo Falcone, Chiara Cremolini  

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.


Question posée
Est-ce que le taux de LDH est prédictif de l’efficacité des anti angiogéniques en 2ème ligne de traitement des cancers colorectaux métastatiques ?
Question posée
Un taux bas de LDH pourrait être le reflet de l’efficacité des anti-angiogéniques.

A confirmer en prospectif sur un plus large effectif.