Received on December 4, 2008
Accepted on March 30, 2009

General Clinical Chemistry

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

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

^* To whom correspondence should be addressed. 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.