CT findings combined with baseline serum lactate dehydrogenase (LDH) levels can predict survival in melanoma patients being treated with antiangiogenic therapy, according to a study presented on Wednesday at the 2013 American Roentgen Ray Society meeting in Washington, DC.
In CT images acquired post-therapy, the study found that changes in tumor morphology, attenuation, size, and structure (MASS criteria) are predictive of survival, said Dr. Andrew Smith of the University of Mississippi in a statement.
In their study, researchers from the University of Mississippi in Jackson and Ohio State University in Columbus analyzed CT images and clinical data from 46 patients with metastatic melanoma who were being treated with bevaciumab antiangiogenic therapy.
Patients with high-baseline serum LDH levels tended to have poor progression-free survival (hazard ratio of 1.32 for each increment of 100, p = 0.001) and overall survival (hazard ratio of 1.42 for each increment of 100, p = 0.001) compared with patients with low serum LDH at baseline, according to Smith.
For the cohort, median progression-free survival was four months and overall survival was 14 months, Smith reported. CT was found to strongly predict both progression-free survival and overall survival (p < 0.001 for both), he concluded.
LDH levels are already used to stage metastatic melanoma, but are only weakly associated with survival when used alone, the authors wrote. But combining the LDH results with MASS criteria findings showed accuracy in predicting both progression-free and overall survival.
The next step is to take the exploratory study results and test them in a prospective clinical trial, Smith said. Patients with low serum LDH and evidence of tumor vascularization should be encouraged that their response to therapy is likely to be favorable, he said.
Nonresponders can be directed to alternative therapies to avoid needless costs and risks from therapy that will not improve their survival or quality of life, Smith said.
