First-line FOLFIRI and bevacizumab in patients with advanced colorectal cancer prospectively stratified according to serum LDH: final results of the GISCAD (Italian Group for the Study of Digestive Tract Cancers) CENTRAL (ColorEctalavastiNTRiAlLdh) trial
Background: Previous findings suggested that bevacizumab might be able to improve response rate (RR) in colorectal cancer patients with high lactic dehydrogenase (LDH) basal levels. Methods: We conducted a phase II trial to prospectively ascertain whether bevacizumab in combination with FOLFIRI coul...
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Published in | British journal of cancer Vol. 117; no. 8; pp. 1099 - 1104 |
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Main Authors | , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
Nature Publishing Group UK
10.10.2017
Nature Publishing Group |
Subjects | |
Online Access | Get full text |
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Summary: | Background:
Previous findings suggested that bevacizumab might be able to improve response rate (RR) in colorectal cancer patients with high lactic dehydrogenase (LDH) basal levels.
Methods:
We conducted a phase II trial to prospectively ascertain whether bevacizumab in combination with FOLFIRI could have an improved clinical activity in patients with high LDH serum levels. Primary end point of the study was RR; secondary end points were median overall survival and median progression-free survival (mPFS).
Results:
A total of 81 patients were enrolled. No difference in terms of ORR (39%
vs
31% for low
vs
high LDH level stratum,
P
=0.78) and mPFS (14.16
vs
10.29 months, HR: 1.07, 95% CI: 0.51–2.24,
P
=0.83) between the strata was observed, whereas overall survival (OS) was significantly longer for patients with low LDH (24.85
vs
15.14 months, HR: 4.08, 95% CI: 1.14–14.61,
P
=0.0004). In a not-pre-planned exploratory analysis using different cut-off ranges for LDH, we observed RR up to 70%, with no improvement in progression-free survival or OS.
Conclusions:
The CENTRAL trial failed to demonstrate that high LDH levels were related to a significantly improved RR in patients receiving first-line FOLFIRI and bevacizumab. The LDH serum levels should then no further be investigated as a predictive factor in this setting. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 Cristian Loretelli15, Laura Casula16, Laura Demurtas16, Valeria Pusceddu16, Pina Ziranu16, Domenico Bilancia17, Luciano Frontini18 and Silvia Rota18 15Medical Oncology Unit, University Hospital and Università Politecnica delle Marche, Ancona, Italy; 16Medical Oncology Unit, University Hospital and University of Cagliari, Cagliari, Italy; 17Medical Oncology Unit, Ospedale San Carlo, Potenza, Italy and 18GISCAD (Italian Group for the Study of Digestive Tract Cancers) Foundation, Milano, Italy Members of the Italian Group for the Study of Gastrointestinal Cancer (GISCAD) are listed above References. |
ISSN: | 0007-0920 1532-1827 |
DOI: | 10.1038/bjc.2017.234 |