Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy
BackgroundHepatic arterial infusion chemotherapy (HAIC) using the FOLFOX regimen has been explored for unresectable hepatocellular carcinoma (HCC) patients, yet predictive biomarkers are lacking. This study aimed to evaluate the potential of serum growth differentiation factor 15 (GDF15) as a biomar...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1619387/full |
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| author | Rui Xing Junyu Gan Jie Mei Jie Mei Zhixiong Li Jing Xu |
| author_facet | Rui Xing Junyu Gan Jie Mei Jie Mei Zhixiong Li Jing Xu |
| author_sort | Rui Xing |
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| description | BackgroundHepatic arterial infusion chemotherapy (HAIC) using the FOLFOX regimen has been explored for unresectable hepatocellular carcinoma (HCC) patients, yet predictive biomarkers are lacking. This study aimed to evaluate the potential of serum growth differentiation factor 15 (GDF15) as a biomarker for predicting therapeutic response and survival outcomes in HCC patients undergoing FOLFOX-HAIC.MethodsPretreatment serum samples were collected from patients with unresectable HCC who received FOLFOX-HAIC between October 2016 and January 2019. GDF15 levels were measured using enzyme-linked immunosorbent assay (ELISA). Associations between serum GDF15 levels and treatment response, overall survival (OS), progression-free survival (PFS), and clinical characteristics were analyzed.ResultsA total of 150 patients were included in the study. The mean GDF15 level was 7.16 ng/mL (mean ± SEM: 7.16 ± 0.72; range: 0.39-53.55 ng/mL). High serum GDF15 levels were significantly associated with poorer treatment response, shorter OS (median: 21.1 vs 40.33 months, p = 0.0081) and PFS (median: 13.93 vs 20.47 months, p = 0.0125). Multivariate Cox proportional hazards analysis identified serum GDF15 as an independent predictor of PFS (HR, 1.521; 95% CI, 1.014-2.283; p = 0.043). Additionally, elevated GDF15 was positively correlated with larger tumor size (p < 0.0001), presence of microvascular invasion (p = 0.026) and abnormal AST levels (p = 0.001).ConclusionSerum GDF15 represents a potential prognostic biomarker in patients with unresectable HCC undergoing FOLFOX-HAIC treatment and may help guide treatment stratification. |
| format | Article |
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| issn | 1664-3224 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj-art-d209d401620c4b17a888916b940e76c32025-07-03T05:26:17ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16193871619387Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapyRui Xing0Junyu Gan1Jie Mei2Jie Mei3Zhixiong Li4Jing Xu5State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaDepartment of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, ChinaBackgroundHepatic arterial infusion chemotherapy (HAIC) using the FOLFOX regimen has been explored for unresectable hepatocellular carcinoma (HCC) patients, yet predictive biomarkers are lacking. This study aimed to evaluate the potential of serum growth differentiation factor 15 (GDF15) as a biomarker for predicting therapeutic response and survival outcomes in HCC patients undergoing FOLFOX-HAIC.MethodsPretreatment serum samples were collected from patients with unresectable HCC who received FOLFOX-HAIC between October 2016 and January 2019. GDF15 levels were measured using enzyme-linked immunosorbent assay (ELISA). Associations between serum GDF15 levels and treatment response, overall survival (OS), progression-free survival (PFS), and clinical characteristics were analyzed.ResultsA total of 150 patients were included in the study. The mean GDF15 level was 7.16 ng/mL (mean ± SEM: 7.16 ± 0.72; range: 0.39-53.55 ng/mL). High serum GDF15 levels were significantly associated with poorer treatment response, shorter OS (median: 21.1 vs 40.33 months, p = 0.0081) and PFS (median: 13.93 vs 20.47 months, p = 0.0125). Multivariate Cox proportional hazards analysis identified serum GDF15 as an independent predictor of PFS (HR, 1.521; 95% CI, 1.014-2.283; p = 0.043). Additionally, elevated GDF15 was positively correlated with larger tumor size (p < 0.0001), presence of microvascular invasion (p = 0.026) and abnormal AST levels (p = 0.001).ConclusionSerum GDF15 represents a potential prognostic biomarker in patients with unresectable HCC undergoing FOLFOX-HAIC treatment and may help guide treatment stratification.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1619387/fullgrowth differentiation factor 15hepatocellular carcinomahepatic arterial infusion chemotherapyserum biomarkeroverall survivalprogression-free survival |
| spellingShingle | Rui Xing Junyu Gan Jie Mei Jie Mei Zhixiong Li Jing Xu Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy Frontiers in Immunology growth differentiation factor 15 hepatocellular carcinoma hepatic arterial infusion chemotherapy serum biomarker overall survival progression-free survival |
| title | Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy |
| title_full | Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy |
| title_fullStr | Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy |
| title_full_unstemmed | Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy |
| title_short | Serum GDF15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy |
| title_sort | serum gdf15 level as predictive biomarker of clinical outcome in patients with unresectable hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy |
| topic | growth differentiation factor 15 hepatocellular carcinoma hepatic arterial infusion chemotherapy serum biomarker overall survival progression-free survival |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1619387/full |
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