Fig. 1: Cachectic and pre-cachectic PDAC patients demonstrate significant differences in stress-related markers at baseline and GDF-15 can be used to classify patients into cachexia categories.

Boxplots showing a log-scale value of all significantly different serum biomarkers between cachectic and non-cachectic PDAC patients (A) and when stratified into 4 stages as in Vigano et al. B NCa = non cachectic, PCa = pre cachectic, Ca = cachectic, RCa = refractory cachectic. All plots in (A, B) are significant based on a Wilcoxon rank sum or Kruskal-Wallis test and BH-adjusted p-value (two-sided hypothesis). Significant differences in serum biomarkers between groups (BH-adjusted pairwise Dunn’s test, two-sided hypothesis) are denoted with a red line in (B). Outliers are denoted by a red dot. C ROC curves for percent self-reported weight loss (Pct Weightloss), GDF-15, TNF-alpha, white blood cell count (WBC), Hemoglobin and Albumin and a combined TNF-alpha * GDF-15 model (Combined Model) using cachexia status at baseline as the “ground truth”. Youden’s optimal thresholds are denoted with a black dot. D Boxplot of percent weight loss (negative values indicate weight gain) from baseline to 6-month follow-up time point. Patients were dichotomized based on levels of GDF-15 (Low vs High based on the Youden’s threshold values calculated by the ROC in Fig. 2C or by the values used in Groarke et al. (37). P-values represent a Wilcoxon rank sum test (two-sided hypothesis).