Cited by 384Bone health and treatmentsBone Metabolism and DiseasesMultiple Myeloma Research and Treatments

A phase I study of AMGN-0007, a recombinant osteoprotegerin construct, in patients with multiple myeloma or breast carcinoma related bone metastases

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Body, Jean-Jacques, Greipp, Philip, Coleman, Robert E., Facon, Thierry, Geurs, Filip, Fermand, Jean-Paul, Harousseau, Jean-Luc, Lipton, Allan +7 more·2003·Cancer

Abstract

BACKGROUND: Osteoprotegerin (OPG) is a decoy receptor for OPG ligand (OPGL), or receptor activator of NF-kappaB ligand (RANKL). RANKL/RANK interaction is important in terminal differentiation and activation of osteoclasts. In binding to RANKL, OPG blocks differentiation and activation of osteoclasts. AMGN-0007 is a recombinant OPG construct developed as a potential therapeutic agent in the treatment of bone disease. METHODS: A randomized, double-blind, double-dummy, active-controlled, single-dose, dose escalation study was conducted to determine the safety and effect on bone resorption of AMGN-0007 in patients with multiple myeloma (n = 28) or breast carcinoma (n = 26) with radiologically confirmed lytic bone lesions. Patients were randomized (3:1 ratio) to receive a single dose of either AMGN-0007 (subcutaneously [SC]) or pamidronate (90 mg intravenously) and were followed for 56 days. Medications or other diseases affecting bone metabolism and chemotherapy within 28 days of dosing were exclusion criteria. Biologic activity of AMGN-0007 was assessed by measurement of the surrogate marker of bone resorption, urinary N-telopeptide of collagen (NTX). RESULTS: AMGN-0007 caused a rapid, sustained, dose-dependent decrease in NTX/creatinine levels, which was at least comparable to the profile observed with pamidronate. Four serious adverse events were reported, three in breast carcinoma patients: a fracture in the left femur (pamidronate, considered unrelated), extreme fatigue (0.3 mg/kg AMGN-0007, considered unrelated), and congestive heart failure (1.0 mg/kg AMGN-0007, considered by the investigator to be probably related to doxorubicin and radiation therapy); one event occurred in a multiple myeloma patient: Herpes zoster (pamidronate, considered unrelated). Two multiple myeloma patients (1.0 mg/kg AMGN-0007) had albumin-adjusted serum calcium levels of 1.9 mmol/L on Day 8 but without clinical symptoms. CONCLUSIONS: A single SC dose of AMGN-0007 suppressed bone resorption as indicated by a rapid, sustained, and profound decrease of urinary NTX/creatinine in multiple myeloma and breast carcinoma patients. Changes were comparable to those with pamidronate. AMGN-0007 was well tolerated.

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  1. Hortobagyi GN, Theriault RL, Lipton A, et al. Long-term prevention of skeletal complications of metastatic breast cancer with pamidronate. J Clin Oncol. 1998;16:2038-2044.

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Authors
Body, J.-J., Greipp, P., Coleman, R. E., Facon, T., Geurs, F., Fermand, J.-P., Harousseau, J.-L., Lipton, A., Mariette, X., Williams, C. D., Nakanishi, A., Holloway, D., Martin, S. W., Dunstan, C. R., & Bekker, P. J.
Affiliations
  • Institut Jules Bordet (BE)
  • Mayo Clinic (US)
  • Weston Park Cancer Centre (GB)
  • Centre Hospitalier Universitaire de Lille (FR)
  • Hôpital Saint-Louis (FR)
  • Penn State Milton S. Hershey Medical Center (US)
  • The Christie Hospital (GB)
  • Amgen (United States) (US)
Corresponding author
Bekker, Pirow J.
Venue
Cancer
Publisher
Wiley
Published
2003-01-23
Volume
97
Issue
S3
Pages
887-892
ISSN
  • 0008-543X (ISSN-L)
  • 1097-0142
OpenAlex
W1986310612
Cited by
383
References
18
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 8 · 2017: 14 · 2016: 7 · 2015: 12 · 2014: 17 · 2013: 19 · 2012: 17
FWCI
17.79
Type
journal article
Language
en
Open access
Locations
  • Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Bone health and treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
  • Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
Keywords
osteoprotegerin, RANKL, RANK, multiple myeloma, breast cancer, bone metastasis, osteolytic lesions, bone resorption, pamidronate, osteoclasts, drug safety, dose escalation, hypercalcemia, congestive heart failure, herpes zoster, phase I
MeSH terms
Pamidronate, Antineoplastic Agents, Bone Neoplasms, Bone Resorption, Breast Neoplasms, Diphosphonates, Dose-Response Relationship, Drug, Double-Blind Method, Female, Glycoproteins, Humans, Male, Middle Aged, Multiple Myeloma, Treatment Outcome, Receptors, Tumor Necrosis Factor, Receptors, Cytoplasmic and Nuclear, Osteoprotegerin

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