Keros Therapeutics has achieved a significant milestone in its development of elritercept, dosing the first patient in the Phase 3 RENEW clinical trial for adults with transfusion-dependent anemia associated with myelodysplastic syndromes (MDS). The initiation triggers a $10 million milestone payment from partner Takeda under their global license agreement.
"The initiation of patient dosing in the RENEW trial marks an important next step in evaluating elritercept as a potentially differentiated therapy for patients with MDS," said Jasbir S. Seehra, Ph.D., Chair and Chief Executive Officer of Keros. "We are pleased to have achieved this milestone alongside our partner Takeda and look forward to seeing elritercept's potential further explored for patients in need."
Phase 3 RENEW Trial Design
The elritercept Phase 3 RENEW clinical trial (NCT06499285) is designed as a global, randomized, double-blind, placebo-controlled study targeting adults with transfusion-dependent anemia who have very low, low, and intermediate risk MDS. The primary objective focuses on evaluating elritercept's efficacy in reducing red blood cell transfusions, addressing a critical unmet need for patients requiring frequent transfusions.
Mechanism of Action and Development Strategy
Elritercept (KER-050) represents an engineered ligand trap comprised of a modified ligand-binding domain of the TGF-β receptor known as activin receptor type IIA, fused to the Fc domain of human antibodies. The therapeutic is being developed to treat cytopenias, including anemia and thrombocytopenia, in patients with MDS and myelofibrosis.
Keros positions itself as a leader in understanding TGF-β family proteins, which serve as master regulators of growth, repair and maintenance across multiple tissues including blood, bone, skeletal muscle, adipose and heart tissue. This expertise has enabled the company to develop protein therapeutics with potential for meaningful and disease-modifying benefits.
Strategic Partnership with Takeda
The global license agreement with Takeda, which became effective January 16, 2025, covers development, manufacturing and commercialization of elritercept worldwide outside of mainland China, Hong Kong and Macau. Under the agreement terms, Keros received a $200 million upfront cash payment in February 2025 and remains eligible for development, commercial and sales milestones potentially exceeding $1.1 billion, plus tiered royalties on net sales.
Company Pipeline and Focus
Beyond elritercept, Keros is developing KER-065 for neuromuscular diseases, with initial focus on Duchenne muscular dystrophy. The company's clinical-stage biopharmaceutical approach centers on developing novel therapeutics for disorders linked to dysfunctional TGF-β family protein signaling.
The advancement of elritercept into Phase 3 testing represents a critical step in addressing treatment gaps for MDS patients who experience transfusion-dependent anemia, a condition that significantly impacts quality of life and long-term outcomes.