Pharmacologic inhibition of myostatin and changes in lean body mass and lower extremity muscle size in patients receiving androgen deprivation therapy for prostate cancer - Abstract

Context: Myostatin is a negative regulator of muscle growth.

Androgen deprivation (ADT) is associated with muscle loss and increased body fat and currently available therapies have limited efficacy to treat this complication. The anti-myostatin peptibody (AMG 745/Mu-S) markedly attenuated muscle loss and decreased fat accumulation in orchiectomized mice.

Objective: The objective was to evaluate safety, pharmacokinetics (PK) and muscle efficacy of AMG 745 in men undergoing ADT for non-metastatic prostate cancer.

Methods: This was a randomized, blinded, placebo-controlled multiple dose phase 1 study of AMG 745 given for 28 days. The endpoint of percent change from baseline in lean body mass (LBM) as assessed by dual x-ray absorptiometry (DXA) was pre-specified.

Results: Rates of adverse events (AMG 745 versus placebo) were: diarrhea (13% versus 9%), fatigue (13% versus 4%), contusion (10% versus 0%), and injection site bruising (6% versus 4%). Exposure increased linearly from 0.3 mg/kg to 3 mg/kg. AMG 745 significantly increased LBM in the 3 mg/kg versus placebo groups on Day 29 by 2.2% (± 0.8% standard error [SE]), p = 0.008; in exploratory fat mass analysis, a decrease - 2.5% (± 1.0% SE), p = 0.021 was observed. Pharmacodynamic changes in muscle and fat were maintained at follow-up, 1 month after Day 29.

Conclusion: Four weekly SC doses of AMG 745 were well tolerated and were associated with increased LBM and decreased fat in the men receiving ADT for non-metastatic prostate cancer. Results support further investigation of AMG 745 in clinical settings with muscle loss and atrophy.

Written by:
Padhi D, Higano CS, Shore N, Sieber P, Rasmussen E, Smith MR.   Are you the author?
Medical Sciences and Biostatistics, Amgen Inc., One Amgen Center Dr, Thousand Oaks, CA; Department of Medicine, University of Washington, and Fred Hutchinson Cancer Research Center, Seattle, WA; Carolina Urologic Research Center, Grand Strand Urology/Atlantic Urology Clinics, Myrtle Beach, SC; Urological Associates of Lancaster, Lancaster, PA; Atara Biotherapeutics, 2659 Townsgate Rd, Ste 236, Thousand Oaks, CA; MA General Hospital Cancer Center, Boston, MA.

Reference: J Clin Endocrinol Metab. 2014 Jun 27:jc20141271.
doi: 10.1210/jc.2014-1271


PubMed Abstract
PMID: 24971661

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