ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1619387
This article is part of the Research TopicImmuno-metabolic Approaches for the Treatment of Hepatobiliary and Pancreatic TumorsView all 4 articles
Serum GDF15 Level as Predictive Biomarker of Clinical Outcome in Patients with Unresectable Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
Provisionally accepted
- Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China
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Hepatic 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.Pretreatment 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.A 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).Serum GDF15 represents a potential prognostic biomarker in patients with unresectable HCC undergoing FOLFOX-HAIC treatment and may help guide treatment stratification.
Keywords: Growth differentiation factor 15, hepatocellular carcinoma, hepatic arterial infusion chemotherapy, serum biomarker HAIC, hepatic arterial infusion chemotherapy, GDF15, growth differentiation factor 15, HCC, hepatocellular carcinoma, OS, overall survival, PFS, Progression-free survival, AFP, alpha-fetoprotein, ALT, alanine aminotransferase, AST, aspartate aminotransferase
Received: 28 Apr 2025; Accepted: 19 Jun 2025.
Copyright: © 2025 Xing, Gan, Mei, Li and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jing Xu, Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China
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