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A first-in-human phase 1 study of a hepcidin monoclonal antibody, LY2787106, in cancer-associated anemia #MMPMID28327200
Vadhan-Raj S; Abonour R; Goldman JW; Smith DA; Slapak CA; Ilaria RL; Tiu RV; Wang X; Callies S; Cox J; Tuttle JL; Lau YK; Roeland EJ
J Hematol Oncol 2017[]; 10 (ä): ä PMID28327200show ga
Background: Hepcidin plays a central role in iron homeostasis and erythropoiesis. Neutralizing hepcidin with a monoclonal antibody (mAb) may prevent ferroportin internalization, restore iron efflux from cells, and allow transferrin-mediated iron transport to the bone marrow. This multicenter, phase 1 study evaluated the safety, pharmacokinetics (PK), pharmacodynamics (PD), and efficacy of a fully humanized mAb (LY2787106) with high affinity for hepcidin in cancer patients with anemia. Methods: Thirty-three patients with hepcidin levels ?5 ng/mL received LY2787106 either every 3 weeks (19 patients, dose range 0.3?10 mg/kg) (part A) or weekly (14 patients, dose 10 mg/kg) (part B). LY2787106 PK/PD markers of iron and hematology biology were measured. Results: LY2787106 clearance (32 mL/h) and volume of distribution (7.7 L) were independent of dose and time, leading to a dose-proportional increase in concentration with dose. Consistent dose-dependent increases in serum iron, and transferrin saturation were seen at the 3 and 10 mg/kg dose levels, typically peaking within 24 h after LY2787106 administration and returning to baseline by day 8. Conclusions: Our findings indicate that LY2787106 was well tolerated in cancer patients with anemia and that targeting the hepcidin-ferroportin pathway by neutralizing hepcidin resulted in transient iron mobilization, thus supporting the role of hepcidin in iron regulation. Trial registration: ClinicalTrial.gov, NCT01340976 Electronic supplementary material: The online version of this article (doi:10.1186/s13045-017-0427-x) contains supplementary material, which is available to authorized users.