Chanhassen – October 28, 2026 -- Every patient with investigator-assessed clinical deterioration in an exploratory 15-patient glioblastoma analysis showed sustained increases in lactate dehydrogenase (LDH) during treatment, Alpheus Medical, Inc. reported at the ESMO Congress 2026 in Madrid.
Poster 4289P tracks LDH trajectories in 15 recurrent glioblastoma patients
The clinical-stage oncology company presented the data from its first-in-human study of Porphyrin Metabolite Activation (PoMA). The cohort comprised 15 patients with MGMT-unmethylated recurrent glioblastoma. Instead of relying on a single LDH value, the analysis examined how LDH changed over time and how those trajectories related to clinical and radiographic disease status.
Stable or falling LDH matched absence of clinical progression
Patients without evidence of clinical disease progression generally showed stable or declining LDH levels. Patients with imaging-based suspected progression generally maintained stable LDH levels. Alpheus said this pattern may give complementary information when radiographic findings are difficult to interpret.
Predefined consecutive LDH increases, or an initial large increase, were more indicative of disease status than smaller isolated changes.
Alpheus plans a prospective study in a larger patient group
CEO Vijay Agarwal, a neurosurgeon, said glioblastoma imaging is difficult because "treatment-related imaging changes can mimic disease progression." The company plans to test serial LDH kinetics prospectively in a larger population, comparing them against clinical status and imaging. The analysis is exploratory, and the company describes LDH only as a potential minimally invasive biomarker.
PoMA combines 5-aminolevulinic acid (5-ALA), which causes protoporphyrin IX to accumulate in tumor cells, with low-intensity defocused ultrasound activation. The approach is under clinical investigation in newly diagnosed glioblastoma (NCT07225621) and butterfly glioblastoma (NCT07862647).