In the August 3rd issue of the New England Journal of Medicine, Corren et al. from Genentech report the results from a phase 2 study of lebrikizumab – a humanized antibody specific for interleukin 13 – in adult patients with asthma. While Genentech is not the only biopharmaceutical company developing antibodies specific for interleukin 13 (IL13) for the treatment of respiratory diseases (e.g. MedImmune CAT-354 and Novartis QAX576), it is the only company so far with a viable patient selection biomarker associated with its drug. Indeed, Corren et al. showed that the positive effect of lebrikizumab treatment on lung function (FEV1) was more pronounced in patients with high serum periostin levels at baseline than in patients with low serum levels of this biomarker.
Since periostin is a cellular matrix protein known to me modulated by IL13 and also known to be upregulated during tissue remodeling in the lung, it is tempting to speculate that serum periostin is a biomarker indicative of a specific asthma IL13-dependent pathobiology. Formal testing of this hypothesis in future clinical studies should yield the necessary evidences to advance periostin as the first patient selection companion diagnostic for a respiratory disease therapy.
Thierry
Sornasse for Integrated Biomarker Strategy
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