Plasma Growth Hormone as a Prognostic Biomarker to Durvalumab and Tremelimumab in Patients with Advanced Hepatocellular Carcinoma

Abstract

Shadi Chamseddine,1,* Michael LaPelusa,2,* Lianchun Xiao,3 Yehia I Mohamed,1 Sunyoung S Lee,1 Zishuo Ian Hu,1 Rikita I Hatia,4 Manal Hassan,4 James C Yao,1 Dan G Duda,5 Saumil Datar,6 Hesham M Amin,7,8 Ahmed O Kaseb1 1Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 2Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 3Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 4Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 5Steele Laboratories, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; 6Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA; 7Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; 8MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA*These authors contributed equally to this workCorrespondence: Hesham M Amin, Department of Hematopathology, The University of Texas MD Anderson Cancer Center, MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences Houston, TX, 77030, USA, Tel [phone], Fax [phone], Email [email protected] Ahmed O Kaseb, Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA, Tel [phone], Fax [phone], Email [email protected]: In this study, we explored the potential of plasma growth hormone (GH) as a prognostic biomarker in patients with advanced HCC treated with durvalumab plus tremelimumab (D+T).Methods: In this study, we included 16 patients with advanced HCC who received D+T at MD Anderson Cancer Center between 2022 and 2023 and had plasma GH measurements recorded before treatment. Plasma GH levels were measured from prospectively collected blood samples and were correlated with progression-free survival (PFS) and overall survival (OS). The cutoff for normal GH levels in women and men was defined as ≤ 3.7 μg/L and ≤ 0.9 μg/L, respectively. The Kaplan–Meier method was employed to compute the median OS and PFS, while the Log rank test was applied to compare the survival outcomes between the GH-high and GH-low groups.Results: Sixteen patients were included in this analysis, two female and fourteen male, with a median age of 65.5 years. At the time of the analysis, the 6-month OS rate was 100% among GH-low patients (6 patients) and 30% among GH-high patients (10 patients). OS was significantly longer in GH-low patients (not evaluable) compared to GH-high patients (3.94 months) (p = 0.030). PFS was also significantly longer in GH-low patients (not evaluable) compared to the GH-high patients (1.87 months) (p = 0.036).Conclusion: Plasma GH is a prognostic biomarker in patients with advanced HCC treated with D+T. Given the relatively small patient cohort size, this finding should be further validated in larger randomized clinical trials in advanced HCC patients.Keywords: hepatocellular carcinoma, growth hormone, durvalumab, tremelimumab, overall survival, progression-free survival

Keywords

• hepatocellular carcinoma
• growth hormone
• durvalumab
• tremelimumab
• overall survival
• progression-free survival