臨床病理学ジャーナル

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Lactate Dehydrogenase-5 (Ldh-5) Immunohistochemical Expression as Predictor of Efficacy of First-Line Therapy in Patients with Advanced Colorectal Cancer Treated with Chemotherapy and Bevacizumab

Garde-Noguera J, Gil-Raga M, Evgenyeva E, Bernet L, Llombart-Cussac A and Camps-Herrer C

Purpose: The aim of this study is to analyse the prognostic role of LDH5 expression measured by immunohistochemistry in patients with advanced colorectal cancer treated with standard chemotherapy with or without bevacizumab. Methods: Retrospective multicentre study, carried out at four hospitals in the Valencian Community (Spain). We investigated the immunohistochemical expression of LDH-5 in a series of 112 patients with advanced colorectal adenocarcinomas treated with oxaliplatin-based chemotherapy with or without bevacizumab. Results: Histological samples for the LDH5 analysis were available for 87 of the 112 patients selected. Sixteen (18.3%) had undetectable or mild expression of LDH5 (Group 1) and 71 (87.7%) showed moderate or high expression of LDH5 (Group 2). Response rate in Group 1 was 56.2% compared to 60.8% in Group 2 (p=0.47). Progression-free survival (PFS) 11 vs. 12 months (p=0.28), and overall survival (OS) 20 vs. 24 months, (p=0.17), were numerically but not significantly higher in patients from Group 2 vs. Group 1. Patients from Group 2 who received bevacizumab presented a significantly higher PFS (13 vs. 12, p=0.039) and a numerically higher OS (27 vs. 20 months, p=0.27) than those treated exclusively with chemotherapy. Conclusions: Our results suggest that the absence or low expression of LDH5 is not associated with a better prognostic profile in patients with advanced colorectal cancer treated with chemotherapy and bevacizumab. Patients with high expression of LDH5, benefit from the combination of chemotherapy with bevacizumab.