Identification of subjects being susceptible to anti-angiogenesis therapy
The present invention relates to a method for identifying a subject being susceptible to anti-angiogenesis therapy based in determining the amount of a cardiac troponin in a sample of the subject and comparing the amount to a suitable reference amount. Also encompassed by the present invention are kits and devices adapted to carry out the method of the present invention.
1. A method for identifying whether a subject under consideration for anti-angiogenic therapy may be suitably treated with a vascular endothelial growth factor (VEGF) antagonist, the method comprising:
conducting an assay to determine an amount of cardiac troponin in a sample from the subject, the assay comprising:
contacting, in vitro, a portion of a sample from the subject with a specific ligand for a cardiac troponin,
calculating an amount of the cardiac troponin based on said contacting,
comparing the calculated amount to a reference amount; and
identifying treatment of the subject with an anti-angiogenic therapy comprising administration of a VEGF antagonist if the calculated amount of cardiac troponin is lower than the reference amount, and
initiating either (i) treatment of the subject with an anti-angiogenic therapy that avoids treatment with a VEGF antagonist or (ii) treatment of the subject with a therapy that is not anti-angiogenic if the calculated amount of cardiac troponin is high than the reference amount.
2. The method of claim 1 , comprising obtaining the sample from the subject not more than one month before initiating a treatment.
3. The method of claim 1 , wherein the subject suffers from cancer.
4. The method of claim 1 , wherein the cardiac troponin is troponin T.
5. The method of claim 1 , wherein the cardiac troponin is troponin T and the reference amount for troponin T is 10 pg/ml.
6. The method of claim 1 , wherein the calculated amount of cardiac troponin is lower than the reference amount, and the method further comprises contacting, in vitro, a portion of a sample from the subject with a specific ligand for a natriuretic peptide, calculating an amount of natriuretic peptide based on the said step of contacting, comparing the amount of natriuretic peptide calculated to a reference amount of natriuretic peptide, and initiating treatment with an anti-angiogenic therapy comprising administration of a VEGF antagonist if the calculated amount of natriuretic peptide is lower than the reference amount of natriuretic peptide, and initiating treatment of the subject with an anti-angiogenic therapy comprising administration of a VEGF antagonist subject to additional monitoring if the calculated amount of natriuretic peptide is greater than the reference amount of natriuretic peptide.
7. The method of claim 6 , wherein the natriuretic peptide is N-terminal pro brain natriuretic peptide (NT-proBNP) and the reference amount for NT-proBNP is 250 pg/ml.
8. The method of claim 7 , wherein the reference amount of cardiac troponin is 10 pg/ml and the reference amount of NT-proBNP is 250 pg/ml.
9. The method of claim 1 , wherein initiating treatment of the subject with a therapy that is not anti-angiogenic comprises administering a PIGF antagonist.
10. The method of claim 1 , wherein the calculated amount of cardiac troponin in the subject is higher thatn the reference amount, and wherein the step of treating the subject with a therapy that is not anti-angiogenic comprises treating the subject with a revascularization therapy.
11. The method according to claim 1 , wherein the VEGF antagonist comprises an anti-VEGF antibody.
12. The method according to claim 11 , wherein the VEGF antibody is selected from bevacizumab and ranibizumab.