Serum Lactate Dehydrogenase in Small-Cell Lung Cancer

1989 ◽  
Vol 320 (1) ◽  
pp. 61-61
Keyword(s):  
Lung Cancer ◽  
Lactate Dehydrogenase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Serum Lactate ◽  
Small Cell ◽  
Serum Lactate Dehydrogenase ◽  
Small Cell Lung

The prognostic significance of pretreatment serum lactate dehydrogenase in patients with small-cell lung cancer.

1991 ◽  
Vol 9 (6) ◽  
pp. 954-961 ◽  
Author(s):  
U Sagman ◽  
R Feld ◽  
W K Evans ◽  
D Warr ◽  
F A Shepherd ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lactate Dehydrogenase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Serum Lactate ◽  
Small Cell ◽  
Serum Lactate Dehydrogenase ◽  
Small Cell Lung ◽  
Normal Range ◽  
Pretreatment Serum

Pretreatment serum lactate dehydrogenase (LDH) levels were assayed in 288 patients presenting with small-cell lung cancer (SCLC) between 1976 and 1985. Patients were routinely staged by physical examination, chest x-ray, bone, brain, and liver scans, and bone marrow evaluation. Clinical response and survival were assessed following treatment with combination chemotherapy as part of four clinical trials. Patients with extensive disease (ED) presented with a higher incidence (108 of 147, 73%) of abnormally elevated LDH (greater than 193 IU/L) than those (65 of 141, 46%) with limited disease (LD) (P = 2 x 10(-6)). Forty percent of patients had an initial normal LDH level and a higher response rate (89 of 108, 82%; complete response [CR], 47%) than those with elevated values of LDH (119 of 156, 76%; CR, 29%). The CR rate varied inversely with the level of LDH in patients with LD (P = .026) but not in those with ED (P = .300). The median survival time and 1-year and 2-year survival rates for patients with elevated LDH were 39 weeks and 33% and 6%, respectively, whereas for those with a normal LDH level these were 53 weeks and 54% and 16%, respectively. Patients with LD and elevated levels of LDH manifested a higher relative death rate (1.63:1) when compared with patients with LD and LDH in the normal range (P = .0083). The survival of patients with ED did not differ between those with normal and elevated levels of LDH (P = .273). A significant survival advantage persisted for patients with LDH in the normal range following adjustments for extent of disease, performance status (PS), and treatment protocol (P = .044, log-rank analysis). In conclusion, serum LDH appears to be a significant independent pretreatment prognostic factor in patients with SCLC that correlates with stage of disease, response to treatment, and survival.

Pre-treatment serum lactate dehydrogenase as a biomarker in small cell lung cancer

2017 ◽  
Vol 14 (2) ◽  
pp. e64-e70 ◽  
Author(s):  
Amy Hsin-Chieh Hsieh ◽  
Harminder Tahkar ◽  
Bogda Koczwara ◽  
Ganessan Kichenadasse ◽  
Kerri Beckmann ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lactate Dehydrogenase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Serum Lactate ◽  
Small Cell ◽  
Serum Lactate Dehydrogenase ◽  
Small Cell Lung ◽  
Pre Treatment

scholarly journals Randomized Phase II Trial of Cisplatin and Etoposide in Combination With Veliparib or Placebo for Extensive-Stage Small-Cell Lung Cancer: ECOG-ACRIN 2511 Study

2019 ◽  
Vol 37 (3) ◽  
pp. 222-229 ◽  
Author(s):  
Taofeek K. Owonikoko ◽  
Suzanne E. Dahlberg ◽  
Gabriel L. Sica ◽  
Lynne I. Wagner ◽  
James L. Wade ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lactate Dehydrogenase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Group Performance ◽  
Small Cell ◽  
Serum Lactate Dehydrogenase ◽  
Small Cell Lung ◽  
End Point ◽  
Extensive Stage

Purpose Veliparib, a poly (ADP ribose) polymerase inhibitor, potentiated standard chemotherapy against small-cell lung cancer (SCLC) in preclinical studies. We evaluated the combination of veliparib with cisplatin and etoposide (CE; CE+V) doublet in untreated, extensive-stage SCLC (ES-SCLC). Materials and Methods Patients with ES-SCLC, stratified by sex and serum lactate dehydrogenase levels, were randomly assigned to receive four 3-week cycles of CE (75 mg/m2 intravenously on day 1 and 100 mg/m2 on days 1 through 3) along with veliparib (100 mg orally twice per day on days 1 through 7) or placebo (CE+P). The primary end point was progression-free survival (PFS). Using an overall one-sided 0.10-level log-rank test, the study had 88% power to demonstrate a 37.5% reduction in the PFS hazard rate. Results A total of 128 eligible patients received treatment on protocol. The median age was 66 years, 52% of patients were men, and Eastern Cooperative Oncology Group performance status was 0 for 29% of patients and 1 for 71%. The respective median PFS for the CE+V arm versus the CE+P arm was 6.1 versus 5.5 months (unstratified hazard ratio [HR], 0.75 [one-sided P = .06]; stratified HR, 0.63 [one-sided P = .01]), favoring CE+V. The median overall survival was 10.3 versus 8.9 months (stratified HR, 0.83; 80% CI, 0.64 to 1.07; one-sided P = .17) for the CE+V and CE+P arms, respectively. The overall response rate was 71.9% versus 65.6% (two-sided P = .57) for CE+V and CE+P, respectively. There was a significant treatment-by-strata interaction in PFS: Male patients with high lactate dehydrogenase levels derived significant benefit (PFS HR, 0.34; 80% CI, 0.22 to 0.51) but there was no evidence of benefit among patients in other strata (PFS HR, 0.81; 80% CI, 0.60 to 1.09). The following grade ≥ 3 hematology toxicities were more frequent in the CE+V arm than the CE+P arm: CD4 lymphopenia (8% v 0%; P = .06) and neutropenia (49% v 32%; P = .08), but treatment delivery was comparable. Conclusion The addition of veliparib to frontline chemotherapy showed signal of efficacy in patients with ES-SCLC and the study met its prespecified end point.

Influence of age on the treatment of limited-stage small-cell lung cancer.

1996 ◽  
Vol 14 (3) ◽  
pp. 821-828 ◽  
Author(s):  
L L Siu ◽  
F A Shepherd ◽  
N Murray ◽  
R Feld ◽  
J Pater ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Performance Status ◽  
Age Groups ◽  
Small Cell ◽  
Serum Lactate Dehydrogenase ◽  
Small Cell Lung ◽  
Limited Stage ◽  
Two Age Groups

PURPOSE To evaluate the prognostic importance of age on response rate and survival in patients with limited-stage small-cell lung cancer (SCLC), and to determine the effect of age on chemotherapy dose delivery and toxicity. PATIENTS AND METHODS We undertook a retrospective analysis of data from two multicenter, randomized trials conducted by the National Cancer Institute of Canada (NCIC) in which 608 SCLC patients who presented with limited disease (LD) all received the same chemotherapy. Treatment consisted of cyclophosphamide, doxorubicin, and vincristine (CAV), and etoposide plus cisplatin (EP) administered in an immediate or delayed alternating fashion, plus cranial and thoracic irradiation. RESULTS There were 520 patients aged less than 70 years, and 88 > or = 70. No significant differences existed between the two age groups in baseline characteristics, including treatment protocol, performance status, and serum lactate dehydrogenase (LDH) level. There were more men in the older group (P = .05). Overall response rates were comparable (78% v 82%, P = .50), and 5-year survival rates were also similar (P = .14), with 11% alive in the younger group and 8% in the older group. Age was a significant predictor of overall survival when analyzed as a continuous variable in a univariate model (P = .01), but it was no longer an independent prognostic factor in our multivariate regression analysis. An analysis of chemotherapy delivery between the two age groups showed that patients aged > or = 70 years received lower total doses of each drug compared with the intended full protocol dose, primarily as a result of dose omissions, rather than dose reductions. The frequency of dose delays was not different between groups. No significant differences were seen in the incidence of either hematologic or most nonhematologic toxicities. CONCLUSION Age is not a significant adverse prognostic variable in SCLC patients with LD. Moderately aggressive chemotherapy may be delivered safely to elderly patients with a good performance status, although modest attenuation of therapy through either dose reduction or omission may occur more frequently in this population.

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