Corelation between Pretreatment Serum LDH levels and Therapeutic response in Cancer patients
*Corresponding Author E-mail: firstname.lastname@example.org
One of the principal biochemical characteristics of malignant cells compared to normal cells is a metabolic switch from oxidative phosphorylation to increased glycolysis, even under hypoxic conditions, and is termed the Warburg effect . Lactate dehydrogenase (LDH) catalyzes the conversion of pyruvate to lactate and is considered to be a key checkpoint of anaerobic glycolysis. It is elevated in many types of cancers and has been linked to tumor growth, maintenance, and invasion; therefore, its inhibition may restrict the energy supply in tumors and thereby reduce the metastatic and invasive potential of cancer cells. This enzyme is receiving a great deal of attention as a potential diagnostic marker or a predictive biomarker for many types of cancer and as a therapeutic target for new anticancer treatment.  Lactate dehydrogenase (LDH) is an enzyme involved in anaerobic glycolysis and regulated by the phosphatidylinositol 3-kinase/Akt/mammalian target of rapamycin (mTOR)-containing complex 1 (PI3K/Akt/TORC1) pathway as well as tumor hypoxia/necrosis This study aimed to investigate whether baseline lactic dehydrogenase (LDH) level, which is a marker of hypoxia, had clinical value in determining therapeutic response and prognosis for cancer patients. High serum LDH levels are associated with poor prognosis in patients with cancer 
Patients and Methods
We evaluated pretreatment and post-treatment serum LDH in 100 cancer patients, with a median follow-up of 12 months
The Shapiro-Wilk test was used to determine the distribution of continuous variables. Student's t-test, chi square, and Ficher exact test were used too. 
Baseline LDH levels 210 IU/L was an independent prognosticator for recurrence-free survival. The predictive value of baseline LDH value remained significant in the subgroup analysis. LDH level <227 IU/L was identified as an independent predictor of complete remission after treatment. It helps distinguish patients with different prognosis and select patients who are more likely to benefit from normal treatment regimens. A highly significant difference was found between the survival patterns of patients with LDH levels of 233 U or less and those with LDH levels greater than 233 U. (recurrence free survival rates were 63% and 74%, respectively.
The association of LDH level with survival was evident even after adjustment for other factors of potential prognostic significance. Pretreatment serum LDH determinations may provide a useful means of stratifying patient populations when comparing treatment programs for cancer types.
Cancer, Lactate dehydrogenase, Metabolism, Anaerobic analysis.