Clinical Chemistry
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Clinical Chemistry 55: 1354-1360, 2009. First published April 30, 2009; 10.1373/clinchem.2008.121285
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(Clinical Chemistry. 2009;55:1354-1360.)
© 2009 American Association for Clinical Chemistry, Inc.

Proteomics and Protein Markers

Hepcidin as a Predictor of Response to Epoetin Therapy in Anemic Cancer Patients

Lidia Ukarma1,a, Hélène Johannes2, Ulrich Beyer1, Michel Zaug1, Bruno Osterwalder1 and Armin Scherhag1,3

1 F. Hoffmann-La Roche Ltd., Basel, Switzerland; 2 DASTA GmbH, Schriesheim, Germany; 3 I. Medical Clinic, University Hospital Mannheim, University of Heidelberg, Germany.

aAddress correspondence to this author at: F. Hoffmann-La Roche Ltd., Bldg. 682/302, Pharmaceutical Division, PDCA, 4070 Basel, Switzerland. Fax +41-61- 688-31-20; e-mail lidia.ukarma{at}roche.com.

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.

Study objectives: 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 (≥13 nmol/L).

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






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Copyright © 2009 by the American Association for Clinical Chemistry.