LDH Level

Hey Jim's wife,

LDH wouldn't be in a "normal" lab work but seems like it's always been requested by all my doctors.  Usually just says LDH and the number.

Here's how I interpret that statement on LDH and survival.  Normally a high LDH is associated with a higher tumor burden.  Doesn't always mean that but it difinitely does sometimes.  To me that statistic is like saying patients with higher tumor burden have a lesser survival percentage.  

Keep in mind that the survival statistic are based on the past.  I think you will start to see the 5 year survival statistic trend up in the next few years because many stage IV patients like myself are starting to hit the 5 year mark.  If my memory serves me right the Anti-PD1 drugs that really started to make a significant improvement to patient outcomes weren't even approved until 2014 or 2015 timeframe.  So even though we are living in much more optimistic times the survival statistics don't really reflect todays reality.

Brian

Hi Jim's Wife, last year checkmate 067 data was published which showed at 3 years 58% of Ipi/Nivo patients and 52% of Nivo patients and 32% of Ipi patients were still alive at 3 years. The trial had 945 patients at the start and broke into three arms of about equal numbers. I have been waiting for an update of the data to see how the survival curves look a year later. The data lags behind by about a year, this January will be my 5th year anniversary on the trial. I am in the Nivo only arm and continue to get treatment every two weeks, I think it is safe to throw away the old survival data that was mainly based on Ipi survival. Here is a link to data if interested! Best Wishes!!!Ed  https://www.nejm.org/doi/10.1056/NEJMoa1709684

Jim's Wife, I often return to this heartening piece by Stephen Jay Gould, who was diagnosed with an abdominal cancer in 1982, read that the median survival was 8 months, and then proceeded to live another 20 years. With encouragement: https://people.umass.edu/biep540w/pdf/Stephen%20Jay%20Gould.pdf