Hepcidin as a predictor of response to epoetin therapy in anemic cancer patients.
BACKGROUND
Hepcidin is thought to be the central regulator of iron metabolism. Iron deficiency is associated with low hepcidin concentrations, and anemia in patients with cancer is associated with high concentrations of hepcidin.


OBJECTIVE
Our main objective was to assess the potential role of hepcidin for predicting response to epoetin therapy in anemic cancer patients. We also aimed to identify a cutoff value for hepcidin as a potential predictive marker for response to epoetin therapy.


METHODS
Using data from 525 anemic cancer patients enrolled in 5 studies, we assessed serum hepcidin concentrations in 408 of these patients at baseline and analyzed pooled data from the 408 patients. The analysis population was separated into 2 categories using a threshold hepcidin concentration of 13 nmol/L: low hepcidin (< 13 nmol/L) and high hepcidin (> or = 13 nmol/L).


RESULTS
A significantly higher percentage of responders (defined as hemoglobin increase > or = 10 g/L or > or = 20 g/L from baseline) was observed in the low hepcidin group compared with the high hepcidin group (P = 0.04 for > or = 10 g/L increase and P = 0.009 for > or = 20 g/L from baseline). There was also a statistically significant difference between the 2 groups for hematopoietic response (hemoglobin rise at least once > or = 20 g/L from baseline or at least once > or = 120 g/L) to epoetin therapy (P = 0.0004).


CONCLUSIONS
The results of this analysis suggest a potential role of hepcidin serum concentrations in predicting the response to epoetin therapy.
Ukarma
Lidia
L
F. Hoffmann-La Roche Ltd., Basel, Switzerland.
Johannes
Hélène
H
Beyer
Ulrich
U
Zaug
Michel
M
Osterwalder
Bruno
B
Scherhag
Armin
A
D000368:Aged; D000740:Anemia / Q000150:complications / Q000188:drug therapy*; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D064451:Hepcidins; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*
D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; C578702:HAMP protein, human; D064451:Hepcidins; D004921:Erythropoietin