Growth-Differentiation-Factor 15 (GDF15) and Hepcidin as Prognostic Biomarkers for Abiraterone-Treated Metastatic Castration-Resistant Prostate Cancer
In brief
High GDF15 marks shorter survival with abiraterone: 12 vs 42 months
In a retrospective study of 28 men with metastatic prostate cancer, those with higher baseline GDF15 had median overall survival of 12 months, compared with 42 months for those with lower levels. GDF15 remained associated with overall survival after adjustment, but not with progression-free survival; hepcidin was not linked to either outcome. Larger prospective studies must validate the finding.
- Journal
- Clinical genitourinary cancer (Q1)
- Published
- 24 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Till Geisendörfer, Andrea Ulrike Steinbicker, Konstantin Egon Seifert, Lisa Schrader, Dorothée Helène Tiedje, Katrin Schlack, et al.
- PMID
- 42888079
- DOI
- 10.1016/j.clgc.2026.102683
Why clinicians should know about it
- Picked for Urology (paper of the day, 20 October 2026): GDF15 prognostic biomarker for abiraterone-treated mCRPC
Abstract
BACKGROUND: Since 2004, several agents prolonging OS in mCRPC have expanded the therapeutic spectrum. Abiraterone is part of the standard of care. Nevertheless, CRPC remains fatal, highlighting the need for new biomarkers to customize the constantly growing treatment choices and sequences to individual patients. METHODS: We retrospectively analyzed serum and demographic data of 28 consecutive patients with mCRPC treated with abiraterone. Baseline serum GDF15 and hepcidin were measured prior to treatment initiation. Because both biomarkers showed right-skewed distributions, they were analyzed as continuous, natural log-transformed variables in Cox regression analyses. Kaplan-Meier analyses using median splits were performed to visualize survival differences. Associations with PFS and OS were examined using univariate and multivariate Cox regression analyses. Multivariate analysis included GDF15, prostate specific antigen-decline by 50% (PSA50) and visceral metastases. RESULTS: Higher baseline ln-transformed GDF15 levels were associated with shorter PFS (HR 1.6; P = .04) and OS (HR 1.8; P < .01) in univariate analysis. Median split Kaplan-Meier analysis showed shorter PFS (8 vs. 13 months, P < .01) and OS (12 vs. 42 months, P < .01) in patients with higher GDF15. In multivariate analyses GDF15 remained independently associated with OS (HR 1.8; P = .01) after adjustment for PSA50 and visceral metastases, whereas the association with PFS was no longer statistically significant. No significant associations between baseline hepcidin and PFS or OS were found. CONCLUSION: Higher baseline serum GDF15 was associated with poor outcomes in patients with mCRPC treated with abiraterone. Further validation as a candidate prognostic biomarker in prospective studies involving larger, independent patient cohorts is recommended.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.