Background: Cachexia is a challenging complication of cancer and its treatment, associated with an increased risk of death. Growth differentiation factor 15 (GDF15) is a known driver of cachexia, with ponsegromab (GDF15 mAb) showing therapeutic success in a Phase II trial conducted in people with lung, pancreatic and colorectal cancer. The role of GDF15 in cachexia aetiology in other cancer types is unknown. The objective of this study is to quantify circulating GDF15 in people with head and neck cancer (HNC) and determine the relationship with indicators of cachexia.
Methods: Adults diagnosed with HNC, scheduled to receive definitive cisplatin-based chemoradiotherapy, were recruited from four tertiary hospitals in Australia and Italy. Cachexia was determined using a variety of clinical parameters, including weight, grip strength, and upper arm circumference (UAC), each assessed at baseline, week 3 and end of treatment. GDF15 was quantified in serially-collected serum using a commercial ELISA.
Results: The results presented in this abstract relate to the N=41 participants recruited from Australia and Milan (Italy). These participants were predominantly male (79%) with a mean age of 65+/-8 years. 87.8% (36/41) participants met the diagnostic criteria for cachexia, with an average weight loss of 9.04% over the course of treatment. This was accompanied by 12% and 12.6% average reductions in grip strength and UAC respectively. Weight loss persisted 3 months beyond treatment end, with an average loss of 10.47% compared to pre-treatment weight. Notably, serum GDF15 levels were highly elevated following chemoradiotherapy compared to baseline (4.5 Fold, P<0.0001), and correlated with reductions in weight (R2=0.2, P=0.0027), UAC (R2=0.1714, P=0.0047) and grip strength (R2=0.3779, P<0.0001).
Conclusions: These pilot data suggest aberrant GDF15 production occurs in HNC patients, identifying a new clinical cohort that may benefit from ponsegromab.