Pretreatment serum lactate dehydrogenase (LDH) is a predictive biomarker for the survival benefit derived from treatment with the TORC1 inhibitor temsirolimus in patients with renal cell carcinoma (RCC), according to a study published online in the Journal of Clinical Oncology.
To assess whether serum LDH is prognostic and has predictive value, Andrew J. Armstrong, MD, of Duke University in Durham, N.C., and colleagues evaluated serum LDH (pretreatment and post-treatment) in 404 poor-risk patients with RCC receiving temsirolimus or interferon alfa treatment during participation in an international phase 3 randomized trial.
The researchers found that mean baseline serum normalized LDH was 1.23 times the upper limit of normal (ULN). Patients with an LDH level greater than 1 × ULN had a 2.8 time increased risk of death compared with patients who had an LDH level of 1 × ULN or less. Overall survival was significantly improved with temsirolimus (6.9 vs. 4.2 months) among the 140 patients with LDH above the ULN. However, overall survival was not significantly improved with temsirolimus compared with interferon therapy among the 264 patients with normal LDH (11.7 and 10.4 months, respectively).
“Serum LDH is a prognostic and a predictive biomarker for the survival benefit conferred by TORC1 inhibition in poor-risk RCC,” the authors wrote.