Document Detail

Metastatic melanoma: lactate dehydrogenase levels and CT imaging findings of tumor devascularization allow accurate prediction of survival in patients treated with bevacizumab.
MedLine Citation:
PMID:  24072776     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To predict survival in patients with metastatic melanoma by evaluating a combination of serum lactate dehydrogenase (LDH) level and initial computed tomographic (CT) findings of tumor devascularization after antiangiogenic therapy.
MATERIALS AND METHODS: Consent was waived for this institutional review board-approved, retrospective, secondary analysis. Forty-four patients with metastatic melanoma received bevacizumab therapy in a randomized prospective phase II trial. Target lesions on the initial posttherapy CT images were evaluated by using Response Evaluation Criteria in Solid Tumors, the Choi criteria, and Morphology, Attenuation, Size, and Structure (MASS) criteria. Cox proportional hazards models were used to assess the association of baseline clinical variables including serum LDH and imaging findings with progression-free and overall survival. The receiver operating characteristic curve with area under the curve (AUC) was used to evaluate accuracy.
RESULTS: In multivariate analysis, a high baseline serum LDH level was associated with decreased progression-free survival (hazard ratio = 1.29 for each increase of 100 IU/L; P = .002) and overall survival (hazard ratio = 1.44 for each increase of 100 IU/L; P = .001). Evaluation with MASS criteria of the first CT examination after therapy strongly predicted progression-free (P < .001) and overall (P < .001) survival. Baseline serum LDH level was moderately accurate for predicting progression-free survival at 9 months (AUC = 0.793) and overall survival at 18 months (AUC = 0.689). The combination of baseline serum LDH levels and evaluation with MASS criteria at the first CT examination after therapy had significantly higher accuracy for predicting progression-free survival at 9 months (AUC = 0.969) and overall survival at 18 months (AUC = 0.813) than did baseline serum LDH levels alone for prediction of progression-free survival (P = .020).
CONCLUSION: A combination of baseline serum LDH levels and evaluation with MASS criteria at the first CT examination after bevacizumab therapy had the highest accuracy for predicting survival in patients with metastatic melanoma.
Mark R Gray; Sara Martin del Campo; Xu Zhang; Haowei Zhang; Frederico F Souza; William E Carson; Andrew D Smith
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Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial     Date:  2013-10-28
Journal Detail:
Title:  Radiology     Volume:  270     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2014 Feb 
Date Detail:
Created Date:  2014-01-29     Completed Date:  2014-03-26     Revised Date:  2014-09-26    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  425-34     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2013
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MeSH Terms
Aged, 80 and over
Angiogenesis Inhibitors / therapeutic use
Antibodies, Monoclonal, Humanized / therapeutic use
Disease Progression
L-Lactate Dehydrogenase / blood*
Melanoma / blood*,  drug therapy*,  pathology,  radiography*
Middle Aged
Neoplasm Metastasis / pathology
Predictive Value of Tests
Prospective Studies
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed
Grant Support
P30 CA016058/CA/NCI NIH HHS; T32 CA090223/CA/NCI NIH HHS
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab; EC Dehydrogenase

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