# Race-based differences in serum biomarkers for cancer-associated cachexia in a diverse cohort of patients with pancreatic ductal adenocarcinoma

## TL;DR

This study finds that the biomarker GDF-15 is linked to cancer-related weight loss in some racial groups but not in Black patients with pancreatic cancer.

## Contribution

The study identifies race-specific differences in the utility of GDF-15 as a biomarker for cancer-associated cachexia.

## Key findings

- GDF-15 was a strong predictor of cachexia severity in Hispanic/Latinx and non-Hispanic White patients.
- High GDF-15 levels were linked to greater weight loss in these groups over six months.
- GDF-15 did not show similar associations in Non-Hispanic Black patients.

## Abstract

Pancreatic ductal adenocarcinoma is projected to become the second leading cause of cancer-related deaths by 2040, with the highest disease burden expected amongst Non-Hispanic Blacks. One of the most significant predictors of poor outcomes is the presence of cancer-associated cachexia (CCa). Yet, race- and ethnicity-specific biomarkers for early CCa diagnosis are lacking. Thus, evaluated a panel of candidate biomarkers of CCa in a diverse cohort of pre-treatment serum. Our study shows that GDF-15 was associated with cachexia severity, was superior to standard CCa-associated biomarkers at classifying cachexia, and differentiated between non-cachexia and pre-cachexia status, but only among Hispanic/Latinx and non-Hispanic Whites. Furthermore, high GDF-15 levels at diagnosis were associated with a ~ 2-fold increase in weight loss over the 6 months post-diagnosis. Thus, GDF-15 may be a potential biomarker for pre-cachexia (prior to weight loss) in the White and the Hispanic population, but not Black individuals. These findings underscore the fact that enrollment of minority individuals in clinical trials to evaluate treatments for CCa is of utmost importance.