METHODS OF TREATING CANCER AND TUMOR-RELATED WEIGHT LOSS AND CACHEXIA

II. SEQUENCE LISTING

The instant application contains a Sequence Listing which has been submitted electronically in XML file format and is hereby incorporated by reference in its entirety. Said XML copy, created on Aug. 29, 2022, is named 47702-0108001_SL.xml and is 546,728 bytes in size.

III. FIELD

The present disclosure relates generally to methods of treating (i) a tumor (e.g., cancer) or (ii) tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-glial cell line-derived neurotrophic factor family receptor alpha-like (GFRAL) antibody, wherein the anti-GFRAL antibody inhibits GFRAL binding to Ret proto-oncogene (RET). The present disclosure also relates generally to methods of treating pancreatic cancer (e.g., advanced pancreatic cancer, pancreatic adenocarcinoma, metastatic pancreatic cancer, metastatic pancreatic adenocarcinoma, microsatellite instability high pancreatic cancer, pancreatic ductal adenocarcinoma, metastatic pancreatic ductal adenocarcinoma) in a human patient, comprising administering to the human patient (i) an anti-GFRAL antibody, wherein the antibody inhibits GFRAL binding to RET; (ii) paclitaxel; and (iii) gemcitabine.

IV. BACKGROUND OF THE INVENTION

Growth differentiation factor 15 (GDF15) is a protein belonging to the transforming growth factor beta (TGF-β) superfamily. GDF15 is also known as TGF-PL, MIC-1, PDF, PLAB, NAG-1, and PTGFB. GDF15 mRNA is reported to be most abundant in the liver, with lower levels seen in some other tissues. Its expression in liver can be significantly up-regulated in injury of organs such as liver, kidney, heart and lung.

GDF15 is reported to play a role in regulating inflammatory and apoptotic pathways in injured tissues and during disease processes. It has been reported that GDF15 is a mediator of cachexia in various diseases. However, cachexia is a complex and incompletely understood syndrome. In addition, at least some tumors over-express and secrete GDF15, and elevated serum GDF15 levels have been associated with various cancers. GDF-15 has been described as a negative regulator of macrophage activation by suppressing the release of TNF-α, IL-1, IL-2 and MCS-F, thus inhibiting the positive feedback of local inflammatory signaling similar to the effects of TGF-β. Monoclonal antibodies against GDF15 have been disclosed as potential therapeutic agents for the treatment of cachexia and of cancer.

There is a significant unmet need for therapeutic agents effective to treat weight loss associated with a number of diseases and conditions, including wasting diseases such as cachexia or sarcopenia and inflammatory conditions such as systemic inflammation or an acute inflammatory response. There is also a significant unmet need for therapeutic agents effective to treat tumors, including in which involuntary body weight loss and/or muscle mass loss is involved.

V. BRIEF SUMMARY OF THE INVENTION

This disclosure relates to dosing human patients in need thereof with therapeutically effective doses of an anti-GDNF Family Receptor Alpha-Like (GFRAL) antibody.

In a first aspect, this disclosure features a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer, e.g., a prostate cancer (e.g., a metastatic castration-resistant prostate cancer (mCRPC), a castration-sensitive prostate cancer, a castration-resistant prostate cancer; an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies (e.g., prostate cancer therapies known in the art or described herein. e.g., leuprolide, abiraterone, enzalutamide, leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin & pemetrexed); a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, a small cell lung cancer (SCLC) (including an extensive-stage SCLC), a non-small cell lung cancer (NSCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma, or an MSI-H (microsatellite instability high) cancer (e.g., an MSI-H prostate cancer, MSI-H ovarian cancer. MSI-H ovarian cancer, MSI-H HNSCC, MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC)) in a human patient. In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). The method comprises administering to the human patient an anti-GFRAL antibody at a dose of about 30 mg about every 3 weeks. In some cases, the method comprises administering to the human patient an anti-GFRAL antibody at a dose of 30 mg every 3 weeks. In some instances, the anti-GFRAL antibody inhibits GFRAL binding to RET.

In a second aspect, this disclosure features a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer, e.g., a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer; an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies (e.g., prostate cancer therapies known in the art or described herein, e.g., leuprolide, abiraterone, enzalutamide, leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin & pemetrexed); a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, a small cell lung cancer (SCLC) (including an extensive-stage SCLC), a non-small cell lung cancer (NSCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma, or an MSI-H (microsatellite instability high) cancer (e.g., an MSI-H prostate cancer, MSI-H ovarian cancer, MSI-H ovarian cancer, MSI-H HNSCC, MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC)) in a human patient. In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). The method comprises administering to the human patient an anti-GFRAL antibody at a dose of about 100 mg about every 3 weeks. The method comprises administering to the human patient an anti-GFRAL antibody at a dose of 100 mg every 3 weeks. In some instances, the anti-GFRAL antibody inhibits GFRAL binding to RET.

In some cases in the above methods, the human patient has a relapsed or a refractory cancer or tumor after receiving one or more anti-cancer therapies. In some instances, the one or more anti-cancer therapies comprise a standard of care therapy for the respective cancer or tumor. In one case, the human patient has metastatic castration-resistant, chemo-refractory prostate cancer. In some cases, the human patient has an MSI-H cancer or tumor. In some cases, the human patient has castration-resistant prostate cancer, and has received one or more lines of cancer therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some cases, the human patient has an advanced prostate cancer (e.g., castration-resistant prostate cancer) and the patient has previously received one, two, three, or more lines of cancer therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In some instances, the tumor is prostate cancer. In some instances, the tumor is advanced prostate cancer. In some instances, the prostate cancer is a castration-sensitive prostate cancer. In some instances, the prostate cancer is an mCRPC. In some instances, the prostate cancer is a castration-resistant prostate cancer. In some instances, the prostate cancer is an MSI-H prostate cancer. In some instances, the prostate cancer is a metastatic prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the tumor is chemo-refractory prostate cancer. In some instances, the tumor is metastatic chemo-refractory prostate cancer. In some instances, the tumor is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the tumor is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the tumor is advanced prostate cancer, wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In some instances, the above methods stabilizes, slows down, or prevents progression of the tumor or cancer. In certain instances, the human patient has tumor-related weight loss or cachexia. In certain instances, the method reduces tumor-related weight loss or cachexia. In some instances, the above methods reduce the serum level of GDF15 in the patients. In some instances, the human patient has castration-resistant prostate cancer, and the methods reduce the serum PSA level in the patient.

In some cases in the above methods, at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody are administered to the human patient. In some cases in the above methods, the human patient is at least 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, or 85 years of age.

In a third aspect, the disclosure provides a method for treating tumor-related weight loss or cachexia in a human patient. The method comprises administering to the human patient an anti-GFRAL antibody at a dose of about 30 mg once about every 3 weeks. In some cases, the method comprises administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks. In some cases, the antibody inhibits GFRAL binding to RET.

In a fourth aspect, the disclosure provides a method for treating tumor-related weight loss or cachexia in a human patient. The method comprises administering to the human patient an anti-GFRAL antibody at a dose of about 100 mg once about every 3 weeks. In some cases, the method comprises administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks. In some cases, the antibody inhibits GFRAL binding to RET

In some instances in the above methods, the human patient is receiving a concomitant anti-cancer therapy. In some instances, the concomitant anti-cancer therapy is a standard of care anti-cancer therapy for the tumor or cancer being treated. In certain cases, the concomitant anti-cancer therapy is a chemotherapy, a radiation therapy, a hormonal therapy, or a surgical therapy. In some cases in the above methods, the human patient has a relapsed or a refractory cancer or tumor after receiving one or more anti-cancer therapies. In some cases, the human patient has castration-resistant prostate cancer, and has received one or more lines of hormone therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some cases, the human patient has an advanced prostate cancer (e.g., castration-resistant prostate cancer) and the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In some cases in all of the above methods, the tumor is a solid tumor. In some cases, the tumor is an advanced solid tumor. In some cases, the tumor is a cancer. In certain cases, the cancer is advanced or metastatic. In certain cases, the cancer is selected from a group consisting of a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, and a head neck squamous cell carcinoma, or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In one instance, the cancer is a pancreatic adenocarcinoma. In certain cases, the administering is performed subcutaneously. In certain cases, the administering is performed intravenously. In some cases in all of the above methods, the human patient has an elevated serum level of GDF15 prior to the administering of the anti-GFRAL antibody compared to the serum level of GDF15 in said human prior to developing the tumor. In some cases in all of the above methods, the human patient has an elevated blood/serum level of GDF15 relative to a blood/serum level of GDF15 in a human not having the tumor or cancer. In some cases in all of the above methods, the human patient has an elevated level of GDF15 in the cancer tissue relative to the same non-cancerous tissue (e.g., in a cancerous prostate tissue relative to a non-cancerous prostate tissue). In certain cases, the human patient has a blood/serum GDF level of at least about 500 pg/mL, at least about 600 pg/mL, at least about 700 pg/mL, at least about 800 pg/mL, at least about 900 pg/mL, at least about 950 pg/mL, at least about 1000 pg/mL, at least about 1200 pg/mL, at least about 1300, at least about 1400 pg/mL, at least about 1500 pg/mL, at least about 1600 pg/mL, at least about 1700 pg/m, at least about 1800 pg/mL, at least about 1900 pg/mL, at least about 2000 pg/mL. In one case, the human patient has a blood/serum GDF level of at least about 950 pg/mL (e.g., prior to the administering of the anti-GFRAL antibody). In another case, the human patient has a blood/serum GDF level of at least about 1300 pg/mL (e.g., prior to the administering of the anti-GFRAL antibody). In some instances, the human patient has a reduced serum GDF15 level after the administering of the anti-GFRAL antibody as compared to the serum GDF15 level in the human patient prior to the administering of the anti-GFRAL antibody. “About” in the context of GDF levels means+/−10% of the recited value. In one case, the human patient has a relapsed or a refractory cancer or tumor after receiving one or more anti-cancer therapies. In certain cases, the human patient has castration-resistant prostate cancer, and has received one or more lines of hormone therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some cases of the above methods, the method further comprises determining the level of beta hydroxybutyrate (BHB) in serum during or following the treatment period. In some instances, the level of BHB in serum is reduced following treatment with the anti-GFRAL antibody. In some cases in the above methods, at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody are administered to the human patient. In some cases in the above methods, the human patient is at least 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, or 85 years of age.

In some instances, the tumor is a prostate cancer. In some instances, the tumor is an advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the prostate cancer is an mCRPC. In some instances, the prostate cancer is a castration-sensitive prostate cancer. In some instances, the prostate cancer is a castration-resistant prostate cancer tumor. In some instances, the prostate cancer is an MSI-H prostate cancer. In some instances, the prostate cancer is a metastatic prostate cancer. In some instances, the tumor is a chemo-refractory prostate cancer. In some instances, the tumor is a metastatic chemo-refractory prostate cancer. In some instances, the tumor is a metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the tumor is an advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the tumor is an advanced prostate cancer, wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In a fifth aspect, the disclosure relates to a method for treating pancreatic cancer in a human patient. The method comprises administering to the human patient an anti-GFRAL antibody at a dose of about 30 mg once about every 4 weeks; paclitaxel (e.g., nab-paclitaxel); and gemcitabine. In some cases, the method comprises administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 4 weeks; paclitaxel (e.g., nab-paclitaxel); and gemcitabine. In some cases, the anti-GFRAL antibody inhibits GFRAL binding to RET. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²gemcitabine once every week. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is a metastatic pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

In a sixth aspect, the disclosure relates to a method for treating pancreatic cancer in a human patient. The method comprises administering to the human patient an anti-GFRAL antibody at a dose of about 100 mg once about every 4 weeks; paclitaxel (e.g., nab-paclitaxel); and gemcitabine. In some cases, the method comprises administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 4 weeks; paclitaxel (e.g., nab-paclitaxel); and gemcitabine. In some cases, the anti-GFRAL antibody inhibits GFRAL binding to RET. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²gemcitabine once every week. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is a metastatic pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

In some instances, the paclitaxel is administered to the human patient twice during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient, and gemcitabine is administered to the human patient twice during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In certain instances, the paclitaxel is administered to the human patient three times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient, and the gemcitabine is administered to the human patient three times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some cases, the paclitaxel is nab-paclitaxel. In cases wherein the paclitaxel is nab-paclitaxel. In some instances, the nab-paclitaxel is administered to the human patient at a dose of 125 mg/m²once every week for three weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week for three weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some cases, the human patient has pancreatic tumor-related weight loss or cachexia. In certain cases, the method reduces pancreatic tumor-related weight loss or cachexia in the human patient. In some cases, the pancreatic cancer is pancreatic adenocarcinoma. In certain cases, the pancreatic cancer is metastatic. In some cases, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some cases, the administering of the anti-GRFAL antibody is performed subcutaneously, whereas the administering of the paclitaxel and gemcitabine is performed intravenously. In some cases, the administering of the anti-GRFAL, the paclitaxel, and the gemcitabine is each performed intravenously. In some cases, the human patient has an elevated serum level of GDF15 prior to the administering of the anti-GFRAL antibody compared to the serum level of GDF15 in said human prior to developing the cancer. In some cases, the human patient has an elevated blood/serum level of GDF15 relative to a blood/serum level of GDF15 in a human not having the cancer. In some cases, the human patient has an elevated level of GDF15 in the cancer tissue relative to the same non-cancerous tissue (e.g., in a cancerous prostate tissue relative to a non-cancerous prostate tissue). In certain cases, the human patient has a blood/serum GDF level of at least about 500 pg/mL, at least about 600 pg/mL, at least about 700 pg/mL, at least about 800 pg/mL, at least about 900 pg/mL, at least about 950 pg/mL, at least about 1000 pg/mL, at least about 1200 pg/mL, at least about 1300, at least about 1400 pg/mL, at least about 1500 pg/mL, at least about 1600 pg/mL, at least about 1700 pg/m, at least about 1800 pg/mL, at least about 1900 pg/mL, at least about 2000 pg/mL. In one case, the human patient has a blood/serum GDF level of at least about 950 pg/mL. In another case, the human patient has a blood/serum GDF level of at least about 1300 pg/mL. In some instances, the human patient has a reduced serum GDF15 level after the administering of the anti-GFRAL antibody as compared to the serum GDF15 level in the human patient prior to the administering of the anti-GFRAL antibody. In one case, the human patient has a relapsed or a refractory cancer or tumor after receiving one or more anti-cancer therapies. In some cases in the above methods, at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody are administered to the human patient. In some cases in the above methods, the human patient is at least 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, or 85 years of age. In some cases, the method further comprises determining the levels of the tumor biomarker CA19-9. In certain cases, the levels of the tumor biomarker CAl9-9 are reduced relative to the level prior to treatment.

In some instances in all of the above methods, the anti-GFRAL antibody specifically binds within amino acid residues 220-316 of the amino acid sequence set forth in SEQ ID NO: 1797. In certain cases, the anti-GFRAL antibody specifically binds to one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19) residues selected from the group consisting of: Met214, Pro216, Pro217, Gln290, Cys291, Thr292, Cys293, Arg294, Thr295, Ile296, Thr297, Gln298, Ser299, Glu301, Lys305, Gln308, His309, His312, and Ser315 of the amino acid sequence set forth in SEQ ID NO: 1797. In some cases, the anti-GFRAL antibody specifically binds to at least Thr297, Gln298, and Ser299 of the amino acid sequence set forth in SEQ ID NO:1797. In some cases, the antibody comprises a heavy chain variable region (VH) and a light chain variable region (VL), and wherein the VH comprises a VH complementarity determining region (CDR)1, a VH CDR2, and a VH CDR3 from the amino acid sequence set forth in SEQ ID NO:1982, and the VL comprises a VL CDR1, a VL CDR2, and a VL CDR3 from the amino acid sequence set forth in SEQ ID NO:1997. In some cases the CDRS are based on one of the following definitions: Exemplary, IMGT, Kabat, Chothia, Contact, or AbM. In some instances, the antibody comprises a VH comprising the three VH CDRs and a VL comprising the three VL CDRs of any one of the six CDR definitions provided in Table 1. In certain cases, the VH comprises an amino acid sequence that has at least 90% sequence identity to the amino acid sequence set forth in SEQ ID NO:1982 and the VL comprises an amino acid sequence that has at least 90% sequence identity to the amino acid sequence set forth in SEQ ID NO: 1997. In other cases, the VH comprises an amino acid sequence that has at least 95% sequence identity to the amino acid sequence set forth in SEQ ID NO:1982 and the VL comprises an amino acid sequence that has at least 95% sequence identity to the amino acid sequence set forth in SEQ ID NO:1997. In yet other cases, the VH comprises the amino acid sequence set forth in SEQ ID NO:1982 and the VL comprises the amino acid sequence set forth in SEQ ID NO:1997. In some cases, the antibody is a human IgG1, human IgG2, or human IgG4 antibody. In certain cases, the antibody is a human IgG1 antibody. In certain instances, the antibody comprises a human kappa light chain constant region. In some instances, the antibody comprises a human lambda light chain constant region. In certain instances, the antibody comprises a heavy chain comprising an amino acid sequence with 80% identity to the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising an amino acid sequence with 80% identity to the amino acid sequence set forth in SEQ ID NO:2012. In other instances, the antibody comprises a heavy chain comprising an amino acid sequence with 90% identity to the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising an amino acid sequence with 90% identity to the amino acid sequence set forth in SEQ ID NO: 2012. In yet other instances, the antibody comprises a heavy chain comprising an amino acid sequence with 95% identity to the amino acid sequence set forth in SEQ ID NO: 2010 and a light chain comprising an amino acid sequence with 95% identity the amino acid sequence set forth in SEQ ID NO: 2012. In some cases, the antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO: 2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO: 2012. In other cases, the antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO: 2010 and a light chain consisting of the amino acid sequence set forth in SEQ ID NO: 2012.

The disclosure also features a method of predicting the efficacy of an anti-GFRAL antibody therapy in a human subject. The method comprises determining the blood or serum level of beta hydroxybutyrate (BHB) following treatment comprising the anti-GFRAL antibody relative to the blood or serum level of BHB in an untreated patient or the serum level of BHB prior to treatment in the human subject. The treatment is likely to be effective (and so can be continued if needed) if the blood or serum levels of BHB are reduced following treatment.

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225, and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma, or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the prostate cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient has castration-resistant prostate cancer. In some instances, the human patient has castration-resistant prostate cancer and previously failed after one or more lines of hormone therapies. In some cases, the human patient has an advanced prostate cancer (e.g., an mCRPC, castration-resistant prostate cancer) and the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated after treatment with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, comprising administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225, and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovanan cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises. (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 30 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer; a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer; a castration-resistant prostate cancer; an MSI-H prostate cancer; a metastatic prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody at a dose of 100 mg once every 3 weeks, wherein the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the administering is performed subcutaneously. In some instances, the administering is performed intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the tumor). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovanan cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

Also provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, the method comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of 30 mg once every 4 weeks; (b) paclitaxel (e.g., nab-paclitaxel), and (c) gemcitabine; wherein the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody is administered to the human patient subcutaneously. In some instances, the anti-GFRAL antibody is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having pancreatic cancer). In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody, paclitaxel, and gemcitabine.

Also provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, the method comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of 30 mg once every 4 weeks; (b) paclitaxel (e.g., nab-paclitaxel), and (c) gemcitabine; wherein the anti-GFRAL antibody comprises: a VH comprising the amino acid sequence set forth in SEQ ID NO:1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody is administered to the human patient subcutaneously. In some instances, the anti-GFRAL antibody is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having pancreatic cancer). In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody, paclitaxel, and gemcitabine.

Also provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, the method comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of 30 mg once every 4 weeks; (b) paclitaxel (e.g., nab-paclitaxel), and (c) gemcitabine; wherein the anti-GFRAL antibody comprises: a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody is administered to the human patient subcutaneously. In some instances, the anti-GFRAL antibody is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having pancreatic cancer). In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody, paclitaxel, and gemcitabine.

Also provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of 100 mg once every 4 weeks; (b) paclitaxel (e.g., nab-paclitaxel), and (c) gemcitabine; wherein the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody is administered to the human patient subcutaneously. In some instances, the anti-GFRAL antibody is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having pancreatic cancer). In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody, paclitaxel, and gemcitabine.

Also provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, the method comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of 100 mg once every 4 weeks; (b) paclitaxel (e.g., nab-paclitaxel), and (c) gemcitabine; wherein the anti-GFRAL antibody comprises: a VH comprising the amino acid sequence set forth in SEQ ID NO:1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody is administered to the human patient subcutaneously. In some instances, the anti-GFRAL antibody is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having pancreatic cancer). In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody, paclitaxel, and gemcitabine.

Also provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of 100 mg once every 4 weeks; (b) paclitaxel (e.g., nab-paclitaxel), and (c) gemcitabine; wherein the anti-GFRAL antibody comprises: a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010 and a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody is administered to the human patient subcutaneously. In some instances, the anti-GFRAL antibody is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the human patient has an elevated level of GDF15 (e.g., compared to a level of GDF15 in a human or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having pancreatic cancer). In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody, paclitaxel, and gemcitabine.

In some instances of the foregoing methods, the human patient has a reduced level of GDF15 (e.g., compared to a baseline level of GDF15 prior to the administering of the anti-GFRAL antibody) after the administering of the anti-GFRAL antibody (e.g., a level that is reduced by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, or at least 95% relative to the baseline level).

In some instances of the foregoing methods, the human patient is about 35 years of age, about 40 years of age, about 45 years of age, about 50 years of age, about 55 years of age, about 60 years of age, about 65 years of age, about 70 years of age, about 75 years of age, about 80 years of age, or about 85 years of age. In some instances of the foregoing methods, the human patient is at least 35 years of age, at least 40 years of age, at least 45 years of age, at least 50 years of age, at least 55 years of age, at least 60 years of age, at least 65 years of age, at least 70 years of age, at least 75 years of age, at least 80 years of age, or at least 85 years of age. In some instances of the foregoing methods, the human patient is 35-90 years of age, 35-80 years of age, 35-70 years of age, 45-90 years of age, 45-80 years of age, 45-70 years of age, 55-90 years of age, 55-80 years of age, 55 to 75 years of age, or 55-65 years of age.

VI. BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a graph showing dose dependent effect of the anti-GFRAL antibody on preventing or reducing cisplatin-induced body weight loss in rats. Values are mean f SEM from n=8 in each group. P values for group 3, group 4 and group 5 were calculated in comparison with group 2 by t-test using the Holm-Sidak method. ns=not significant. Day 21: lines are Group 1, Group 5, Group 4, Group 6, Group 3, and Group 2, respectively, from top to bottom.

FIG. 2A is a series of graphs showing the effect of the anti-GFRAL antibody on body weight gain in healthy human volunteers. The percentage change of body weight relative to the baseline body weight in each subject was plotted. Each line represents a subject.

FIG. 2B is a chart showing exemplary body weight changes on day 85.

FIG. 3 is a graph showing serum concentrations of the anti-GFRAL antibody following administration at a frequency of once every 3 weeks in subjects diagnosed with various cancers including colorectal cancer, pancreatic cancer, prostate cancer, bladder cancer, and esophageal cancer. Each line represents a subject. Top 7 lines at day 40 correspond to the 100 mg Antibody dose; the rest of the lines correspond to the 30 mg Antibody dose.

FIG. 4 is a graph showing lean body mass change in subjects undergoing the treatment of the anti-GFRAL antibody. Each line represents a subject. Square, diamond, circle, point-up triangle, and point-down triangle correspond to the 100 mg Antibody dose; the rest of the data points correspond to the 30 mg Antibody dose.

FIG. 5 is a graph showing serum concentrations of the anti-GFRAL antibody following administration of the antibody together with gemcitabine and abraxane in subjects diagnosed with metastatic pancreatic cancer. Each line represents a subject.

FIG. 6 is a graph showing tumor progression in 8 metastatic pancreatic cancer patients during the treatment of the anti-GFRAL antibody in combination with gemcitabine and abraxane. SD is an abbreviation for Stable Disease; PR is an abbreviation for Partial Response; NE is an abbreviation for Not Evaluable.

FIG. 7 is a graph showing percentage changes of CA19-9 levels in circulation from the baseline level in metastatic pancreatic cancer patients undergoing the combination therapy. Solid lines represent CA19-9 positive patients. The dotted line represents a CA19-9 negative patient. 4 patients received 30 mg of the anti-GFRAL antibody together with gemcitabine and abraxane, 2 patients received 100 mg of the anti-GFRAL antibody together with gemcitabine and abraxane.

FIG. 8 is a graph showing the percentage change of lean body mass in 6 metastatic pancreatic cancer patients undergoing the combination therapy. 4 patients received 30 mg of the anti-GFRAL antibody together with gemcitabine and abraxane. 2 patients received 100 mg of the anti-GFRAL antibody together with gemcitabine and abraxane.

FIG. 9 is a graph showing the percentage change of body weight in 6 metastatic pancreatic cancer patients undergoing the combination. 4 patients received 30 mg of the anti-GFRAL antibody together with gemcitabine and abraxane. 2 patients received 100 mg of the anti-GFRAL antibody together with gemcitabine and abraxane.

FIG. 10A shows alignments of VH sequences of humanized 5F12 antibodies. SEQ ID NOS are noted in parenthesis and bold text.

FIG. 10B shows alignments of VL sequences of humanized 5F12 antibodies. SEQ ID NOS are noted in parenthesis and bold text.

VII. DETAILED DESCRIPTION OF THE INVENTION

The present disclosure relates generally to methods of (i) treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, or (ii) treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an antibody that binds to GFRAL (an “anti-GFRAL antibody”), at a dose of about 30 mg once about every 3 weeks or about 100 mg once about every 3 weeks, wherein the antibody inhibits GFRAL binding to RET. In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In instances, the tumor is a cancer. In some instances, the cancer is an advanced solid tumor. In some instances, the cancer is a prostate cancer, a bladder cancer, a melanoma, a small cell lung cancer (SCLC) (including an extensive-stage SCLC), a non-small cell lung cancer (NSCLC), a pancreatic cancer, a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma, or an MSI-H (microsatellite instability high) cancer. The prostate cancer can include, for example, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a chemo-refractory prostate cancer, a prostate cancer where the patient has previously received one or more, two or more, or one or more (e.g., 1, 2, 3, or more) lines of standard prostate cancer therapies, or an advanced prostate cancer where the patient has exhausted all standard lines of therapies. A pancreatic cancer can include, for example, an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, or a metastatic pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is a metastatic pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. An MSI-H cancer can include, for example, an MSI-H prostate cancer, an MSI-H bladder cancer, an MSI-H melanoma, an MSI-H small cell lung cancer (SCLC) (including an extensive-stage SCLC), an MSI-H non-small cell lung cancer (NSCLC), an MSI-H pancreatic cancer, an MSI-H colorectal cancer, an MSI-H gastric cancer, an MSI-H esophageal cancer, an MSI-H ovarian cancer, or an MSI-H head and neck squamous cell carcinoma. In some instances, the patient has an elevated level of GDF15 in the serum compared to the baseline level of GDF15 thereof without the tumor. In some instances, the antibody is administered subcutaneously. In some instances, the antibody is administered intravenously. As used herein throughout, in the context of a dose, “about” means+/−10% of the recited dose. For instance, “about 30 mg” means “27 mg to 33 mg” and “about 100 mg” means “90 mg to 110 mg”. As used herein throughout, in the context of a duration of time, “about” means+/−one week. For instance, “about 3 weeks” means “2 weeks to 4 weeks” and “about 4 weeks” means “3 weeks to 5 weeks”. The present disclosure also relates generally to methods of treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, comprising administering to the human patient. (i) an anti-GFRAL antibody at a dose of about 30 mg once about every 4 weeks or a dose of about 100 mg once about every 4 weeks; (ii) paclitaxel (e.g., nab-paclitaxel); and (iii) gemcitabine; wherein the anti-GFRAL antibody inhibits GFRAL binding to RET. In some cases, the antibody is administered subcutaneously and the paclitaxel and gemcitabine are each administered intravenously. In some cases, the antibody, paclitaxel, and gemcitabine are each administered intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once every week. In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²gemcitabine once every week.

The term “treat” or “treatment” or “treating” or “to treat” as used herein refers to therapeutic measures that aim to relieve, slow down progression of, lessen symptoms of, and/or halt progression of a pathologic condition or disorder. Thus, those in need of treatment include those already with the disorder.

Unless explained otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art to which this disclosure belongs.

A. GFRAL, GDF15, and RET

Human GDNF Family Receptor Alpha Like (GFRAL, also known in the art as GDF15 receptor, C6orf144, Chromosome 6 Open reading Frame 144, BA360D14.1, IVF19356, and UNQ9356) is a 375-amino acid (excluding the signal peptide) protein that acts as a receptor for GDF15 signaling.

The amino acid sequence of a full-length precursor human GFRAL is provided below and includes a signal peptide sequence (lowercase residues):

(SEQ ID NO: 1797)

mivfiflamglsleneytsQTNNCTYLREQCLRDA

NGCKHAWRVMEDACNDSDPGDPCKMRNSSYCNLSI

QYLVESNFQFKECLCTDDFYCTVNKLLGKKCINKS

DNVKEDKFKWNLTTRSHHGFKGMWSCLEVAEACVG

DVVCNAQLASYLKACSANGNPCDLKQCQAAIRFFY

QNIPFNIAQMLAFCDCAQSDIPCQQSKEALHSKTC

AVNMVPPPTCLSVIRSCQNDELCRRHYRTFQSKCW

QRVTRKCHEDENCISTLSKQDLTCSGSDDCKAAYI

DILGTVLQVQCTCRTITQSEESLCKIFQHMLHRKS

CFNYPTLSNVKGMALYTRKHANKITLTGFHSPFNG

EVIYAAMCMTVTCGILLLVMVKLRTSRISSKARDP

SSIQIPGEL.

The amino acid sequence of a mature human GFRAL polypeptide is provided below:

(SEQ ID NO: 1798)

QTNNCTYLREQCLRDANGCKHAWRVMEDACNDSDP

GDPCKMRNSSYCNLSIQYLVESNFQFKECLCTDDF

YCTVNKLLGKKCINKSDNVKEDKFKWNLTTRSHHG

FKGMWSCLEVAEACVGDVVCNAQLASYLKACSANG

NPCDLKQCQAAIRFFYQNIPFNIAQMLAFCDCAQS

DIPCQQSKEALHSKTCAVNMVPPPTCLSVIRSCQN

DELCRRHYRTFQSKCWQRVTRKCHEDENCISTLSK

QDLTCSGSDDCKAAYIDILGTVLQVQCTCRTITQS

EESLCKIFQHMLHRKSCFNYPTLSNVKGMALYTRK

HANKITLTGFHSPFNGEVIYAAMCMTVTCGILLLV

MVKLRTSRISSKARDPSSIQIPGEI.

Human GFRAL has an extracellular domain (e.g., residues 20-351 of the amino acid sequence set forth in SEQ ID NO: 1797), a transmembrane domain (e.g., residues 352-371 of the amino acid sequence set forth in SEQ ID NO: 1797) and a cytoplasmic domain (e.g., residues 372-394 of the amino acid sequence set forth in SEQ ID NO: 1797).

GDF15 (also known in the art as MIC-1 (macrophage inhibitory cytokine-1), PDF (prostate differentiation factor), PLAB (placental bone morphogenetic protein), NAG-1 (non-steroidal anti-inflammatory drugs (NSAIDs) activated gene), TGF-PL, and PTGFB), is a member of the transforming growth factor β (TGF-β) super-family. GDF15, which is synthesized as a 62 kDa intracellular precursor protein that is subsequently cleaved by a furin-like protease, is secreted as a 25 kDa disulfide-linked protein (see, e.g., Fairlie et al., J. Leukoc. Biol 65:2-5 (1999)). GDF15 mRNA is seen in several tissues, including liver, kidney, pancreas, colon and placenta, and GDF15 expression in liver can be significantly up-regulated during injury of organs such as the liver, kidneys, heart and lungs.

The GDF15 precursor is a 308 amino acid polypeptide (NCBI Ref. Seq. NP_004855.2; GI:153792495) containing a 29 amino acid signal peptide, a 167 amino acid pro-domain, and a mature domain of 112 amino acids which is excised from the pro-domain by furin-like proteases.

An amino acid sequence of a precursor human GDF15 polypeptide is provided below:

(SEQ ID NO: 1810)

MPGQELRTVNGSQMLLVLLVLSWLPHGGALSLAEA

SRASFPGPSELHSEDSRFRELRKRYEDLLTRLRAN

QSWEDSNTDLVPAPAVRILTPEVRLGSGGHLHLRI

SRAALPEGLPEASRLHRALFRLSPTASRSWDVTRP

LRRQLSLARPQAPALHLRLSPPPSQSDQLLAESSS

ARPQLELHLRPQAARGRRRARARNGDHCPLGPGRC

CRLHTVRASLEDLGWADWVLSPREVQVTMCIGACP

SQFRAANMHAQIKTSLHRLKPDTVPAPCCVPASYN

PMVLIQKTDTGVSLQTYDDLLAKDCHCI.

Such a 308-amino acid GDF15 polypeptide is referred to as a “full-length” GDF15 polypeptide; a 112-amino acid GDF15 polypeptide (amino acids 197-308 of “full-length” GDF15) is a “mature” GDF15 polypeptide. An amino acid sequence of a mature human GDF15 polypeptide is provided below:

(SEQ ID NO: 1811)

ARNGDHCPLGPGRCCRLHTVRASLEDLGWADWVLS

PREVQVTMCIGACPSQFRAANMHAQIKTSLHRLKP

DTVPAPCCVPASYNPMVLIQKTDTGVSLQTYDDLL

AKDCHCI.

“RET” (also known in the art as Ret Proto-Oncogene, Cadherin-Related Family Member 16. Rearranged During Transfection, RET Receptor Tyrosine Kinase, Cadherin Family Member 12, Proto-Oncogene C-Ret, EC 2.7.10.1, CDHF12, CDHR16, RET51, PTC, Hydroxyaryl-Protein Kinase, RET Transforming Sequence, and Receptor Tyrosine Kinase) is one of the receptor tyrosine kinases, cell-surface molecules that transduce signals for cell growth and differentiation. RET acts as a co-receptor and is known as a primary signaling receptor for glial-cell-line-derived neurotrophic factor (GDNF) ligands (in human, GDNF, artemin, neurturin, and persephin) when bound to members of the GDNF receptor alpha (GFRα) co-receptors. A RET protein (e.g., a RET-ECD) comprises 4 consecutive cadherin-like domains (CLD1-CLD4) followed by a membrane proximal cysteine rich domain (CRD). RET protein is a co-receptor with a GFRAL protein and a GDF15 protein (e.g., acting as a co-receptor with a RET protein). A receptor complex includes a GFRAL protein, such as a RET/GFRAL complex, a GFRAL/GDF15 complex, and a RET/GFRAL/GDF15 complex.

RET is distinct from TGFβ RI and TGFβ RII. SEQ ID NO: 1812 is the sequence of a mature human RET9 that lacks a signal peptide:

(SEQ ID NO: 1812)

KVALGLYFSRDAYWEKLYVDQAAGTPLLYVHALRD

APEEVPSFRLGQHLYGTYRTRLHENNWICIQEDTG

LLYLNRSLDHSSWEKLSVRNRGFPLLTVYLKVFLS

PTSLREGECQWPGCARVYFSFFNTSFPACSSLKPR

ELCFPETRPSFRIRENRPPGTFHQFRLLPVQFLCP

NISVAYRLLEGEGLPFRCAPDSLEVSTRWALDREQ

REKYELVAVCTVHAGAREEVVMVPFPVTVYDEDDS

APTFPAGVDTASAVVEFKRKEDTVVATLRVFDADV

VPASGELVRRYTSTLLPGDTWAQQTFRVEHWPNET

SVQANGSFVRATVHDYRLVLNRNLSISENRTMQLA

VLVNDSDFQGPGAGVLLLHFNVSVLPVSLHLPSTY

SLSVSRRARRFAQIGKVCVENCQAFSGINVQYKLH

SSGANCSTLGVVTSAEDTSGILFVNDTKALRRPKC

AELHYMVVATDQQTSRQAQAQLLVTVEGSYVAEEA

GCPLSCAVSKRRLECEECGGLGSPTGRCEWRQGDG

KGITRNFSTCSPSTKTCPDGHCDVVETQDINICPQ

DCLRGSIVGGHEPGEPRGIKAGYGTCNCFPEEEKC

FCEPEDIQDPLCDELCRTVIAAAVLFSFIVSVLLS

AFCIHCYHKFAHKPPISSAEMTFRRPAQAFPVSYS

SSGARRPSLDSMENQVSVDAFKILEDPKWEFPRKN

LVLGKTLGEGEFGKVVKATAFHLKGRAGYTTVAVK

MLKENASPSELRDLLSEFNVLKQVNHPHVIKLYGA

CSQDGPLLLIVEYAKYGSLRGFLRESRKVGPGYLG

SGGSRNSSSLDHPDERALTMGDLISFAWQISQGM

QYLAEMKLVHRDLAARNILVAEGRKMKISDFGLSR

DVYEEDSYVKRSQGRIPVKWMAIESLFDHIYTTQ

SDVWSFGVLLWEIVTLGGNPYPGIPPERLFNLLKT

GHRMERPDNCSEEMYRLMLQCWKQEPDKRPVFAD

ISKDLEKMMVKRRDYLDLAASTPSDSLIYDDGLS

EEETPLVDCNNAPLPRALPSTWIENKLYGRISHA

FTRF

The amino acid sequence of a full-length precursor human RET protein is provided below and includes a signal peptide sequence (lowercase residues):

(SEQ ID NO: 1813)

makatsgaaglrlllllllpllgkvalgLYFSRDA

YWEKLYVDQAAGTPLLYVHALRDAPEEVPSFRLGQ

HLYGTYRTRLHENNWICIQEDTGLLYLNRSLDHSS

WEKLSVRNRGFPLLTVYLKVFLSPTSLREGECQWP

GCARVYFSFFNTSFPACSSLKPRELCFPETRPSFR

IRENRPPGTFHQFRLLPVQFLCPNISVAYRLLEGE

GLPFRCAPDSLEVSTRWALDREQREKYELVAVCTV

HAGAREEVVMVPFPVTVYDEDDSAPTFPAGVDTAS

AVVEFKRKEDTVVATLRVFDADVVPASGELVRRYT

STLLPGDTWAQQTFRVEHWPNETSVQANGSFVRAT

VHDYRLVLNRNLSISENRTMQLAVLVNDSDFQGPG

AGVLLLHFNVSVLPVSLHLPSTYSLSVSRRARRFA

QIGKVCVENCQAFSGINVQYKLHSSGANCSTLGVV

TSAEDTSGILFVNDTKALRRPKCAELHYMVVATDQ

QTSRQAQAQLLVTVEGSYVAEEAGCPLSCAVSKRR

LECEECGGLGSPTGRCEWRQGDGKGITRNFSTCSP

STKTCPDGHCDVVETQDINICPQDCLRGSIVGGHE

PGEPRGIKAGYGTCNCFPEEEKCFCEPEDIQDPLC

DELCRTVIAAAVLFSFIVSVLLSAFCIHCYHKFAH

KPPISSAEMTFRRPAQAFPVSYSSSGARRPSLDSM

ENQVSVDAFKILEDPKWEFPRKNLVLGKTLGEGEF

GKVVKATAFHLKGRAGYTTVAVKMLKENASPSELR

DLLSEFNVLKQVNHPHVIKLYGACSQDGPLLLIVE

YAKYGSLRGFLRESRKVGPGYLGSGGSRNSSSLDH

PDERALTMGDLISFAWQISQGMQYLAEMKLVHRDL

AARNILVAEGRKMKISDFGLSRDVYEEDSYVKRSQ

GRIPVKWMAIESLFDHIYTTQSDVWSFGVLLWEIV

TLGGNPYPGIPPERLFNLLKTGHRMERPDNCSEEM

YRLMLQCWKQEPDKRPVFADISKDLEKMMVKRRDY

LDLAASTPSDSLIYDDGLSEEETPLVDCNNAPLPR

ALPSTWIENKLYGRISHAFTRF

B. Anti-GFRAL Antibodies that Bind to a GFRAL Protein

The present disclosure provides antibodies that bind to GFRAL (e.g., human GFRAL) (also referred to herein as “anti-GFRAL antibodies”) and may be used in the methods of treating described herein. In some instances, an anti-GFRAL antibody described herein inhibits GFRAL binding to RET. Methods of determining whether an anti-GFRAL antibody inhibits GFRAL binding to RET are known in the art, such as, e.g., co-immunoprecipitation, immunohistochemistry, and ELISA (see, e.g., International Patent Application Publication No. WO 2017/172260, which is incorporated by reference herein in its entirety).

In some instances, an anti-GFRAL antibody comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, VH CDR3, VL CDR1, VL CDR2 and VL CDR3 are from any one of the VH and VL sequences of the antibodies described herein (e.g., 3P10, 5F12, 2I23, 6N16, 1B3, 6G9, or 2B11), such as the amino acid sequences depicted in Tables 1-7. In some instances, the anti-GFRAL antibody is a humanized version of an antibody described herein, (e.g., 3P10, 5F12, 2I23, 6N16, 1B3, 6G9, or 2B11). The antibody designated 3P10 comprises a VH sequence that is set forth in SEQ ID NO: 3 and a VL sequence that is set forth in SEQ ID NO: 4 (see Table 1). In some instances, a humanized 3P10 antibody comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:3, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:4. The antibody designated 5F12 comprises a VH sequence that is set forth in SEQ ID NO: 7 and a VL sequence that is set forth in SEQ ID NO: 8 (see Table 2). In some instances, a humanized 5F12 comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:7, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:8 The antibody designated 2I23 comprises a VH sequence that is set forth in SEQ ID NO: 21 and a VL sequence that is set forth in SEQ ID NO: 22 (see Table 3). In some instances, a humanized 2I23 comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1. VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:21, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:22. The antibody designated 6N16 comprises a VH sequence that is set forth in SEQ ID NO: 23 and a VL sequence that is set forth in SEQ ID NO: 24 (see Table 4). In some instances, a humanized 6N16 antibody comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:23, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:24. The antibody designated 1B3 comprises a VH sequence that is set forth in SEQ ID NO: 25 and a VL sequence that is set forth in SEQ ID NO: 26 (see Table 5). In some instances, a humanized 1B3 antibody comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:25, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:26. The antibody designated 609 comprises a VH sequence that is set forth in SEQ ID NO: 37 and a VL sequence that is set forth in SEQ ID NO: 38 (see Table 6). In some instances, a humanized 6G9 antibody comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:37, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:38. The antibody designated 2B11 comprises a VH sequence that is set forth in SEQ ID NO: 39 and a VL sequence that is set forth in SEQ ID NO: 40 (see Table 7). In some instances, a humanized 2B11 antibody comprises a VH comprising a VH CDR1, a VH CDR2, a VH CDR3, and a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3, wherein the VH CDR1, VH CDR2, and VH CDR3 are from the amino acid sequence of SEQ ID NO:39, and the VL CDR1, VL CDR2 and VL CDR3 are from the amino acid sequence of SEQ ID NO:40.

TABLE 1

Antibody 3P10 CDR Sequences

Exemplary
IMGT
Kabat
Chothia
Contact
AbM

VH CDR
VHCDR1
GYTFTDY
GYTFTDY
DYGVI
GYTFTDY
TDYGVI
GYTFT

Seq.

GVI
G
(SEQ ID
(SEQ ID
(SEQ ID
DYGVI

(SEQ ID
(SEQ ID
NO: 48)
NO: 49)
NO: 50)
(SEQ ID

NO: 46)
NO: 47)

NO: 46)

VH CDR2
WINTYTG
INTYTGE
WINTYTG
TYTG
WMGWINT
WINTY

EPTYAD
P
EPTYAD
(SEQ ID
YTGEP
TGEPT

DLKG
(SEQ ID
DLKG
NO: 139)
T
(SEQ ID

(SEQ ID
NO: 138)
(SEQ ID

(SEQ ID
NO: 141)

NO: 137)

NO: 137)

NO: 140)

VH CDR3
RYGPEDI
ARRYGPE
RYGPEDI
YGPEDID
ARRYGPE
RYGPE

DY
DIDY
DY
(SEQ ID
DID
DIDY

(SEQ ID
(SEQ ID
(SEQ ID
NO: 227)
(SEQ ID
(SEQ ID

NO: 225)
NO: 226)
NO: 225)

NO: 228)
NO: 225)

VL CDR
VL CDR1
RASESVD
ESVDNYG
RASESVD
SESVDNY
DNYGISF
RASESV

Seq.

NYGISF
ISF
NYGISF
GISF
MSWF
DNYGIS

MS
(SEQ ID
MS
(SEQ ID
(SEQ IDF
MS

(SEQ ID
NO: 302)
(SEQ ID
NO: 303)
NO: 304)
(SEQ ID

NO: 301)

NO: 301)

NO: 301)

VL CDR2
AASHQGS
AAS
AASHQGS
AAS
LLIYAAS
AASHQGS

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
HQG

NO: 376)
NO: 377)
NO: 376)
NO: 377)
(SEQ ID
(SEQ ID

NO: 378)
NO: 376)

VL CDR3
LQSKEVP
LQSKEVP
LQSKEVP
SKEVP
LQSKEVP
LQSKE

WT
WT
WT
W
W
VPWT

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 426)
NO: 426)
NO: 426)
NO: 427)
NO: 428)
NO: 426)

VH Sequence:

QIQLVQSGPELKKPGETVKISCKASGYTFTDYGVIWVKQAPGKALKWMGWINTYT

GEPTYADDLKGRFAFSLETSASSASLQINNLKNEDTATYPCA

RRYGPEDIDYWGQGTTLTVSS (SEQ ID NO: 3)

VL Sequence:

DIVLTQSPVSLAVSLGQRATISCRASESVDNYGISFMSWFQQKPGQPPKLLIYAA

SHQGSGVPARFSGSGSGTDFSLNIHPMEEDDSAMYFCLQSKEVP

WTFGGGTKLEIK (SEQ ID NO: 4)

TABLE 1A

Hz3P10 VH, VL, heavy chain (HC), and

light chain (LC) Sequences

VH
QVQLVQSGAEVKKPGSSVKVSCKAS

GYTFTDYGVIWVRQAPGQGLEWMGW

INTYTGEPTYADDLKGRVTFTADES

TSTAYMELSSLRSEDTAVYYCARRY

GPEDIDYWGQGTTVTVSS

(SEQ ID NO: 1982)

VL
DVVLTQSPLSLPVTLGQPASISCRA

SESVDNYGISFMSWFQQRPGQSPRL

LIYAASHQGSGVPDRFSGSGSGIDF

ILKISRVEAEDVGVYFCLQSKEVPW

TFGGGTKVEIK

(SEQ ID NO: 1997)

HC (with signal

MDMRVPAQLLGLLLLWLRGARCQVQ

sequence in
LVQSGAEVKKPGSSVKVSCKASGYT

bold; VH + heavy
FTDYGVIWVRQAPGQGLEWMGWINT

chain
YTGEPTYADDLKGRVTFTADEST

constant region)
STAYMELSSLRSEDTAVYYCARRYG

PEDIDYWGQGTTVTVSSASTKGPSV

FPLAPSSKSTSGGTAALGCLVKDYF

PEPVTVSWNSGALTSGVHTFPAVLQ

SSGLYSLSSVVTVPSSSLGTQTYIC

NVNHKPSNTKVDKKVEPKSCDKTHT

CPPCPAPALAGGPSVFLFPPKPKDT

LMISRTPEVTCVVVDVSHEDPEVKF

NWYVDGVEVHNAKTKPREEQYNSTY

RVVSVLTVLHQDWLNGKEYKCKVSN

KALPAPIEKTISKAKGQPREPQVYT

LPPSREEMTKNQVSLTCLVKGFYPS

DIAVEWESNGQPENNYKTTPPVLDS

DGSFFLYSKLTVDKSRWQQGNVFSC

SVMHEALHNHYTQKSLSLSPGK

(SEQ ID NO: 2009)

HC (without
QVQLVQSGAEVKKPGSSVKVSCKAS

signal sequence;
GYIHDYGVIWVRQAPGQGLEWMGWI

VH + heavy
NTYTGEPTYADDLKGRVTFTADEST

chain constant
STAYMELSSLRSEDTAVYYCARRYG

region)
PEDIDYWGQGTTVTVSSASTKGPSV

FPLAPSSKSTSGGTAALGCLVKDYF

PEPVTVSWNSGALTSGVHTFPAVLQ

SSGLYSLSSVVTVPSSSLGTQTYIC

NVNHKPSNTKVDKKVEPKSCDKTHT

CPPCPAPALAGGPSVFLFPPKPKDT

LMISRTPEVTCVVVDVSHEDPEVKF

NWYVDGVEVHNAKTKPREEQYNSTY

RVVSVLTVLHQDWLNGKEYKCKVSN

KALPAPIEKTISKAKGQPREPQVYT

LPPSREEMTKNQVSLTCLVKGFYPS

DIAVEWESNGQPENNYKTTPPVLDS

DGSFFLYSKLTVDKSRWQQGNVFSC

SVMHEALHNHYTQKSLSLSPGK

(SEQ ID NO: 2010)

LC (with signal

MDMRVPAQLLGLLLLWLRGARCDVV

sequence in
LTQSPLSLPVTLGQPASISCRASES

bold; VL + kappa
VDNYGISFMSWFQQRPGQSPRLLIY

light chain
AASHQGSGVPDRFSGSGSGTDFTLK

constant region)
ISRVEAEDVGVYFCLQSKEVPWTFG

GGTKVEIKRTVAAPSVFIFPPSDEQ

LKSGTASVVCLLNNFYPREAKVQWK

VDNALQSGNSQESVTEQDSKDSTYS

LSSTLTLSKADYEKHKVYACEVTHQ

GLSSPVTKSFNRGEC

(SEQ ID NO: 2011)

LC (without signal
DVVLTQSPLSLPVTLGQPASISCRA

sequence;
SESVDNYGISFMSWFQQRPGQSPRL

VL + kappa light
LIYAASHQGSGVPDRFSGSGSGTDF

chain
TLKISRVEAEDVGVYFCLQSKEVPW

constant region)
TFGGGTKVEIKRTVAAPSVFIFPPS

DEQLKSGTASVVCLLNNFYPREAKV

QWKVDNALQSGNSQESVTEQDSKDS

TYSLSSTLTLSKADYEKHKVYACEV

THQGLSSPVTKSFNRGEC

(SEQ ID NO: 2012)

TABLE 2

Antibody 5F12 CDR Sequences

Exemplary
IMGT
Kabat
Chothia
Contact
AbM

VH CDR
VH CDR1
GYTFTDY
GYTFTDY
DYYIN
GYTFTDY
TDYYIN
GYTFT

Seq.

YIN
Y
(SEQ ID
(SEQ ID
(SEQ ID
DYYIN

(SEQ ID
(SEQ ID
NO: 58)
NO: 49)
NO: 59)
(SEQ ID

NO: 56)
NO: 57)

NO: 56)

VH CDR2
RIYPGNG
IYPGNGN
RIYPGNG
PGNG
WIARIYP
RIYPG

NTYHNE
T
NTYHNE
(SEQ ID
GNGNTY
NGNT

KFKG
(SEQ ID
KFKG
NO: 149)
(SEQ ID
Y

(SEQ ID
NO: 148)
(SEQ ID

NO: 150)
(SEQ ID

NO: 147)

NO: 147)

NO: 151)

VH CDR3
EGLYYDY
AREGLYY
EGLYYDY
GLYYDYD
AREGLYY
EGLYYDY

DRYFD
DYDRY
DRYFD
RYFD
DYDRY
DRYFD

Y
FDY
Y
(SEQ ID
FD
Y

(SEQ ID
(SEQ ID
(SEQ ID
NO: 235)
(SEQ ID
(SEQ ID

NO: 233)
NO: 234)
NO: 233)

NO: 236)
NO: 233)

VL CDR
VL CDR1
RASESVD
ESVDTYG
RASESVD
SESVDTY
DTYGNSF
RASESVD

Seq.

TYGNSF
NSF
TYGNSF
GNSF
MHWY
TYGNSF

MH
(SEQ ID
MH
(SEQ ID
(SEQ ID
MH

(SEQ ID
NO: 310)
(SEQ ID
NO: 311)
NO: 312)
(SEQ ID

NO: 309)

NO: 309)

NO: 309)

VL CDR2
LASNLES
LAS
LASNLES
LAS
LLIYLAS
LASNLES

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
NLE
(SEQ ID

NO: 382)
NO: 383)
NO: 382)
NO: 383)
(SEQ ID
NO: 382)

NO: 384)

VL CDR3
HQNNEDP
HQNNEDP
HQNNEDP
NNEDPP
HQNNEDP
HQNNEDP

PA
PA
PA
(SEQ ID
P
PA

(SEQ ID
(SEQ ID
(SEQ ID
NO: 433)
(SEQ ID
(SEQ ID

NO: 432)
NO: 432)
NO: 432)

NO: 434)
NO: 432)

VH Sequence:

QVQLKQSGTELVRPGASVKLSCKASGYTFTDYYINWVKQRPGQG

LEWIARIYPUNGNTYHNEKFKGKATLTAEKSSSTAYMQLSSLTS

EDSAVYFCAREGLYYDYDRYFDYWGQGTALTVSS

(SEQ ID NO: 7)

VL Sequence:

NIVLTQSPASLAVSLGQRATISCRASESVDTYGNSFMHWYQQKP

GQPPKLLIYLASNLESGVPARFSGSGSRTDFTLTIDPVEADDAA

TYYCHQNNEDPPAFGGGTKLEIK (SEQ ID NO: 8)

TABLE 3

Antibody 2123 CDR Sequences

Exemplary
IMGT
Kabat
Chothia
Contact
AbM

VH
VH
GYSFTSY
GYSFTSY
SYNID
GYSFTSY
TSYNID
GYSFTSY

CDR
CDR1
NID
N
(SEQ ID
(SEQ ID
(SEQ ID
NID

Seq.

(SEQ ID
(SEQ ID
NO: 88)
NO: 89)
NO: 90)
(SEQ ID

NO: 86)
NO: 87)

NO: 86)

VH
WIFPGDG
IFPGDGS
WIFPGDG
PGDG
WIGWIFP
WIFPGDG

CDR2
ST
T
STKYNE
(SEQ ID
GDGSTK
STK

(SEQ ID
(SEQ ID
KFKG
NO: 168)
(SEQ ID
(SEQ ID

NO: 177)
NO: 178)
(SEQ ID

NO: 180)
NO: 181)

NO: 179)

VH
SGIYYGS
ARSGIYY
SGIYYGS
GIYYGSH
ARSGIYY
SGIYYGS

CDR3
HFVY
GSHFVY
HFVY
FV
GSHFV
HFVY

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 261)
NO: 262)
NO: 261)
NO: 263)
NO: 264)
NO: 261)

VL
VL
RSSQSLL
QSLLDSD
RSSQSLL
SQSLLDS
LDSDGKT
RSSQSLL

CDR
CDR1
DSDGKT
GKTY
DSDGKT
DGKTY
YLNWL
DSDGKT

Seq.

YEN
(SEQ ID
YEN
(SEQ ID
(SEQ ID
YEN

(SEQ ID
NO: 338)
(SEQ ID
NO: 339)
NO: 340)
(SEQ ID

NO: 337)

NO: 337)

NO: 337)

VL
LVSKVDS
LVS
LVSKVDS
LVS
RLIYLVS
LVSKVDS

CDR2
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
KVD
(SEQ ID

NO: 401)
NO: 386)
NO: 401)
NO: 386)
(SEQ ID
NO: 401)

NO: 402)

VL
WQGTHFP
WQGTHFP
WQGTHFP
GTHFPL
WQGTHFP
WQGTHFP

CDR3
LT
LT
LT
(SEQ ID
L
LT

(SEQ ID
(SEQ ID
(SEQ ID
NO: 454)
(SEQ ID
(SEQ ID

NO: 453)
NO: 453)
NO: 453)

NO: 455)
NO: 453)

VH Sequence:

QAQLQQSGAELVKPGASVKLSCKASGYSFTSYNIDWVRQRPEQGLE

WIGWIFPGDGSTKYNEKFKGQATLTTDKSSSTTYIHLSRLTSEDSA

VYFCARSGIYYGSHFVYWGQGTLVTVSA (SEQ ID NO: 21)

VL Sequence:

DVVMTQTPLTLSVTIGQSASISCRSSQSLLDSDGKTYLNWLLQRPG

QSPKRLIYLVSKVDSGVPDRFTGSGSGTDFTLKISRVEAEDLGVYF

CWQGTHFPLTFGAGTKLELK (SEQ ID NO: 22)

TABLE 4

Antibody 6N16 CDR Sequences

Exemplary
IMGT
Kabat
Chethla
Contact
AbM

VH CDR
VH CDR1
GYTFTSY
GYTFTSY
SYNIN
GYTPTSY
TSY
GYTFTSY

Seq.

NIN
N
(SEQ ID
(SEQ ID
NIN
NIN

(SEQ ID
(SEQ ID
NO: 93)
NO: 75)
(SEQ ID
(SEQ ID

NO: 91)
NO: 92)

NO: 94)
NO: 91)

VH CDR2
WIFPGDD
IFPGDDS
WIFPGDD
PGDD
WIGWIFP
WIFPGDD

SIKYNE
I
SIKYNE
(SEQ ID
GDDSIK
SIK

NFRG
(SEQ ID
NFRG
NO: 184)
(SEQ ID
(SEQ ID

(SEQ ID
NO: 183)
(SEQ ID

NO: 185)
NO: 186)

NO: 182)

NO: 182)

VH CDR3
SGIFY
ARSGIFY
SGIFYGN
GIYGN
ARSGIFY
SGIFY

GNNFAY
GNNFAY
NFAY
NFA
GNNFA
GNNFAY

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 265)
NO: 266)
NO: 265)
NO: 267)
NO: 268)
NO: 265)

VL CDR
VL CDR1
KSSQSLL
QSLLDGD
KSSQSLL
SQSLLDG
LDGDGET
KSSQSLL

Seq.

DGDGET
GETY
DGDGET
DGETY
YLSWL
DGDGET

YLS
(SEQ ID
YLS
(SEQ ID
(SEQ ID
YLS

(SEQ ID
NO: 342)
(SEQ ID
NO: 343)
NO: 344)
(SEQ ID

NO: 341)

NO: 341)

NO: 341)

VL CDR2
LVSKLDS
LVS
LVSKLDS
LVS
RLIYLVS
LVSKLDS

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
KLD
(SEQ ID

NO: 385)
NO: 386)
NO: 385)
NO: 386)
(SEQ ID
NO: 385)

NO: 403)

VL CDR3
CQSTHFP
CQSTHFP
CQSTHFP
STHFPL
CQSTHFP
CQSTHFP

LT
LT
LT
(SEQ ID
L
LT

(SEQ ID
(SEQ ID
(SEQ ID
NO: 457)
(SEQ ID
(SEQ ID

NO: 456)
NO: 456)
NO: 456)

NO: 458)
NO: 456)

VH Sequence:

SELVKPGTSMKLSCKASGYTF TSYNINWVRLRPEQGLEWIGW

IFPGDDSIKYNENFRGKATLTTDKSSSTAYMHLSRLTSDDSAV

YFCAQVQLQQSGFAYWGQGTLVTVSA (SEQ ID NO: 23)

RSGIFYGNN

VL Sequence:

DVVMTQAPLILSVTIGQPASISCKSSQSLLDGDGETYLSWLLQ

RPGQSPKRLIYLVSKLDSGVPDRFTGSGSGTDFTLKISRVEAE

DLGVYYCCQSTHFPLTFGAGTKLELK

(SEQ ID NO: 24)

TABLE 5

Antibody 1B3 CDR Sequences

Exemplary
IMGT
Kabat
Chothia
Contact
AbM

VH CDR
VH CDR1
GFTFTGY
GFTFTGY
GYNIN
GFTFTGY
TGYNIN
GFTFTGY

Seq.

NIN
N
(SEQ ID
(SEQ ID
(SEQ ID
NIN

(SEQ ID
(SEQ ID
NO: 97)
NO: 98)
NO: 99)
(SEQ ID

NO: 95)
NO: 96)

NO: 95)

VH CDR2
WIFPGDD
IFPGDDN
WIFPGDD
PGDD
WIGWIFP
WIFPGDD

NAKYNE
A
NAKYNE
(SEQ ID
GDDNAK
NAK

KFKG
(SEQ ID
KFKG
NO: 184)
(SEQ ID
(SEQ ID

(SEQ ID
NO: 188)
(SEQ ID

NO: 189)
NO: 190)

NO: 187)

NO: 187)

VH CDR3
TPVLSNY
ARTPVLS
TPVLSNY
PVLSNYF
ARTPVLS
TPVLSNY

FDY
NYFDY
FDY
D
NYFD
FDY

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 269)
NO: 270)
NO: 269)
NO: 271)
NO: 272)
NO: 269)

VL CDR
VL CDR1
KASQDIS
QDISKY
KASQDIS
SQDISKY
SKYISWY
KASQDIS

Seq.

KYIS
(SEQ ID
KYIS
(SEQ ID
(SEQ ID
KYIS

(SEQ ID
NO: 346)
(SEQ ID
NO: 347)
NO: 348)
(SEQ ID

NO: 345)

NO: 345)

NO: 345)

VL CDR2
YTSTLQP
YTS
YTSTLQP
YTS
LLIHYTS
YTSTLQP

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
TLQ
(SEQ ID

NO: 404)
NO: 405)
NO: 404)
NO: 405)
(SEQ ID
NO: 404)

NO: 406)

VL CDR3
LQYDNLY
LQYDNLY
LQYDNLY
YDNLY
LQYDNLY
LQYDNLY

T
T
T
(SEQ ID
(SEQ ID
T

(SEQ ID
(SEQ ID
(SEQ ID
NO: 460)
NO: 461)
(SEQ ID

NO: 459)
NO: 459)
NO: 459)

NO: 459)

VH Sequence:

QVHLQQPGAELVKPGASVKLSCKASGFTFTGYNINWVRLRPEQGLEWI

GWIFPGDDNAKYNEKFKGKATLTTDKSSNTAYMQLSRLTSEDSAVYFC

ARTPVLSNYFDYWGQGTTLTVSS (SEQ ID NO: 25)

VL Sequence:

DIQMTQSPSSLSASLGGKVTITCKASQDISKYISWYQHKPGKSPRLLI

HYTSTLQPGIPSRFSGSGSGRDYSFSISNLEPEDIATYYCLQYDNLYT

FGGGTKLEIK (SEQ ID NO: 26)

TABLE 6

Antibody 6G9 CDR Sequences

Exemplary
IMGT
Kabat
Chothia
Contact
AbM

VH CDR
VH CDR1
GYTFTSY
GYTFTSY
SYWMQ
GYTFTSY
TSYWMQ
GYTFTSY

Seq.

WMQ
W
(SEQ ID
(SEQ ID
(SEQ ID
WMQ

(SEQ ID
(SEQ ID
NO: 125)
NO: 75)
NO: 126)
(SEQ ID

NO: 124)
NO: 73)

NO: 124)

VH CDR2
EIDPSDS
IDPSDSY
EIDPSDS
PSDS
WIGEIDP
EIDPSDS

YTNYNQ
T
YTNYNQ
(SEQ ID
SDSYTN
YTN

KFKG
(SEQ ID
KFKG
NO: 212)
(SEQ ID
(SEQ ID

(SEQ ID
NO: 211)
(SEQ ID

NO: 213)
NO: 214)

NO: 210)

NO: 210)

VH CDR3
PLDRSAY
ARPLDRS
PLDRSAY
LDRSAYY
ARPLDRS
PLDRSAY

Y IDY
AYYFDY
YFDY
FD
AYYFD
YFDY

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 289)
NO: 290)
NO: 289)
NO: 291)
NO: 292)
NO: 289)

VL CDR
VL CDR1
RASES
ESVDFS
RASESVD
SESVDFS
DFSGNSF
RASESVD

Seq.

VDFSG
GNS
FSGNSF
GNSF
MHWY
FSGNSF

NSF
F
MH
(SEQ ID
(SEQ ID
MH

MH
(SEQ ID
(SEQ ID
NO: 367)
NO: 368)
(SEQ ID

(SEQ ID
NO: 366)
NO: 365)

NO: 365)

NO: 365)

VL CDR2
RASNLDS
RAS
RASNLDS
RAS
LLIYRAS
RASNLDS

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
NLD
(SEQ ID

NO: 418)
NO: 419)
NO: 418)
NO: 419)
(SEQ ID
NO: 418)

NO: 420)

VL CDR3
QQSNEDP
QQSNEDP
QQSNEDP
SNEDPY
QQSNEDP
QQSNEDP

YT
YT
YT
(SEQ ID
Y
YT

(SEQ ID
(SEQ ID
(SEQ ID
NO: 475)
(SEQ ID
(SEQ ID

NO: 474)
NO: 474)
NO: 474)

NO: 476)
NO: 474)

VH Sequence:

QVQLHQPGAELVKPGASVKLSCKTSGYTFTSYWMQWVKQRPGQGLEWI

GEIDPSDSYTNYNQKFKGKATLTVDTSSTTAYMQLSSLTSEDSAVYYC

ARPLDRSAYYFDYWGQGTTLTVSS (SEQ ID NO: 37)

VL Sequence:

DIVLTQSPASLAVSLGQRATISCRASESVDFSGNSFMHWYQQKPGQPP

KLLIYRASNLDSGIPARFSGVGSRTDFTLTINPVEADDVATYYCQQSN

EDPYTFGGGTKLEIE (SEQ ID NO: 38)

TABLE 7

Antibody 2B11 CDR Sequences

Exemplary
IMGT
Kabat
Chothia
Contact
AbM

VH CDR
VH CDR1
GYSITSG
GYSITSG
SGYYW
GYSITSG
TSGY
GYSITSG

Seq.

YYWN
YY
N
Y
YWN
YYWN

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 127)
NO: 128)
NO: 129)
NO: 130)
NO: 131)
NO: 127)

VH CDR2
HIANDGS
IANDGSN
HIANDGS
NDG
WMGHIAN
HIANDGS

NYYNPF
(SEQ ID
NYYNPF
(SEQ ID
DGSNY
NY

LKH
NO: 216)
LKH
NO: 217)
(SEQ ID
(SEQ ID

(SEQ ID

(SEQ ID

NO: 218)
NO: 219)

NO: 215)

NO: 215)

VH CDR3
GGSYFDY
ARGGSYF
GGSYFDY
GSYFDYV
ARGGSYF
GGSYFDY

VDY
DYVDY
VDY
D
DYVD
VDY

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID

NO: 293)
NO: 294)
NO: 293)
NO: 295)
NO: 296)
NO: 293)

VL CDR
VL CDR1
RASQDIS
QDISNY
RASQDIS
SQDISNY
SNYLNWY
RASQDIS

Seq.

NYLN
(SEQ ID
NYLN
(SEQ ID
(SEQ ID
NYLN

(SEQ ID
NO: 370)
(SEQ ID
NO: 371)
NO: 372)
(SEQ ID

NO: 369)

NO: 369)

NO: 369)

VL CDR2
YTSRLHS
YTS
YTSRLHS
YTS
LLIYYTS
YTSRLHS

(SEQ ID
(SEQ ID
(SEQ ID
(SEQ ID
RLH
(SEQ ID

NO: 421)
NO: 405)
NO: 421)
NO: 405)
(SEQ ID
NO: 421)

NO: 422)

VL CDR3
QQGNTLP
QQGNTLP
QQGNTLP
GNTLPF
QQGNTLP
QQGNTLP

FT
FT
FT
(SEQ ID
F
FT

(SEQ ID
(SEQ ID
(SEQ ID
NO: 478)
(SEQ ID
(SEQ ID

NO: 477)
NO: 477)
NO: 477)

NO: 479)
NO: 477)

VH Sequence:

DVQLQESGPGLVKPSQSLSLTCSVTGYSITSGYYWNWIRQFPGNKL

EWMGHIANDGSNYYNPFLKHRVSITRDTSKNQFFLKLNSVTIQDTA

TYYCARGGSYFDYVDYWGQGTTLTVSS (SEQ ID NO: 39)

VL Sequence:

DIQMTQTTSSLSASLGDRVTINCRASQDISNYLNWYQQKPDGTVKL

LIYYTSRLHSGVPSRFSGSGSGTDYSLTITNLEQEDIATYFCQQGN

TLPFTFGSGTKLEIK (SEQ ID NO: 40)

CDRs of an antibody are defined using a variety of methods/systems by those skilled in the art. These systems and/or definitions have been developed and refined over a number of years and include Kabat, Chothia, IMGT, AbM, and Contact. The Kabat definition is based on sequence variability and is commonly used. The Chothia definition is based on the location of the structural loop regions. The IMGT system is based on sequence variability and location within the structure of the variable domain. The AbM definition is a compromise between Kabat and Chothia. The Contact definition is based on analyses of the available antibody crystal structures. An Exemplary system is a combination of Kabat and Chothia. Software programs (e.g., abYsis) are available and known to those of skill in the art for analysis of antibody sequences and determination of CDRs. It will be understood that reference in this disclosure to a VH CDR or VH CDRs and/or a VL CDR or VL CDRs of a specific antibody, including a specific VH amino acid sequence and/or a VL amino acid sequence, will encompass all CDR definitions as known to those of skill in the art.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 1; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 1.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 2; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 2.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 3; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 3.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 4; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 4.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 5; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 5.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 6; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 6.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising a VH CDR1, a VH CDR2, and a VH CDR3 defined by any one of the CDR definitions from Table 7; and (ii) a VL comprising a VL CDR1, a VL CDR2, and a VL CDR3 defined by any one of the CDR definitions from Table 7.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:3; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:4 (i.e., the six CDRs of antibody 3P10 of Table 1). In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:1982, and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:1997 (i.e., the six CDRs of a humanized 3P10 antibody of Table 1A).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO: 8 (i.e., the six CDRs of antibody 5F12).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 21; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in EQ ID NO: 22 (i.e., the six CDRs of antibody 2I23).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 23; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO: 24 (i.e., the six CDRs of antibody 6N16).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 25; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO: 26 (i.e., the six CDRs of antibody 1B3).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 37; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO: 38 (i.e., the six CDRs of antibody 6G9).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 39, and 1958-1965; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO: 38 (i.e., the six CDRs of antibody 2B11).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in any one of SEQ ID NOs: 1958-1965; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in any one of SEQ ID NOs: 1967-1976 (i.e., the six CDRs of a humanized 5F12 antibody).

In some instances, the CDRs of the anti-GFRAL antibody are according to the Exemplary designation. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Exemplary designation in Table 2; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Exemplary designation in any one of Table 2.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Exemplary designation in Table 3: and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Exemplary designation in Table 3.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Exemplary designation in Table 4; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Exemplary designation in Table 4.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Exemplary designation in Table 5; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Exemplary designation in Table 5.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Exemplary designation in Table 6; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Exemplary designation in Table 6.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Exemplary designation in Table 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Exemplary designation in Table 7.

In some instances, the CDRs of the anti-GFRAL antibody are according to the IMGT designation. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:47, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:138, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:226; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:302, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:377, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the IMGT designation in Table 2; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the IMGT designation in Table 2.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the IMGT designation in Table 3; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the IMGT designation in Table 3.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the IMGT designation in Table 4; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the IMGT designation in Table 4.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the IMGT designation in Table 5; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the IMGT designation in Table 5.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the IMGT designation in Table 6; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the IMGT designation in Table 6.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the IMGT designation in Table 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the IMGT designation in Table 7.

In some instances, the CDRs of the anti-GFRAL antibody are according to the Kabat designation. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Kabat designation in Table 2; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Kabat designation in Table 2.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Kabat designation in Table 3; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Kabat designation in Table 3.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Kabat designation in Table 4; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Kabat designation in Table 4.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Kabat designation in Table 5; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Kabat designation in Table 5.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Kabat designation in Table 6; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Kabat designation in Table 6.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Kabat designation in Table 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Kabat designation in Table 7.

In some instances, the CDRs of the anti-GFRAL antibody are according to the Chothia designation. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:49, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:139, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:227; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:303, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:377, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:427.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Chothia designation in Table 2; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Chothia designation in Table 2.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Chothia designation in Table 3; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Chothia designation in Table 3.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Chothia designation in Table 4; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Chothia designation in Table 4.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Chothia designation in Table 5; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Chothia designation in Table 5.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Chothia designation in Table 6; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Chothia designation in Table 6.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Chothia designation in Table 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Chothia designation in Table 7.

In some instances, the CDRs of the anti-GFRAL antibody are according to the Contact designation. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:50, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:140, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:228; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:304, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:378, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:428.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Contact designation in Table 2; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Contact designation in Table 2.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Contact designation in Table 3; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Contact designation in Table 3.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Contact designation in Table 4; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Contact designation in Table 4.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Contact designation in Table 5; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Contact designation in Table 5.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Contact designation in Table 6; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Contact designation in Table 6.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the Contact designation in Table 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the Contact designation in Table 7.

In some instances, the CDRs of the anti-GFRAL antibody are according to the AbM designation. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:141, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the AbM designation in Table 2; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the AbM designation in Table 2.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the AbM designation in Table 3; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the AbM designation in Table 3.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the AbM designation in Table 4; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the AbM designation in Table 4.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the AbM designation in Table 5; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the AbM designation in Table 5.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the AbM designation in Table 6; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the AbM designation in Table 6.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 according to the AbM designation in Table 7; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 according to the AbM designation in Table 7.

In certain embodiments, the anti-GFRAL antibody comprises a humanized framework region (FR) sequence, e.g., as described herein. In certain embodiments, the anti-GFRAL antibody described herein comprises a VH comprising a VH FR1, a VH FR2, a VH FR3 and a VH FR4 amino acid sequence described in International Patent Application Publication No. WO 2017/172260, which is incorporated by reference herein in its entirety; and/or (b) a VL comprising a VL FR1, a VL FR2, a VL FR3 and a VL FR4 amino acid sequence described in International Patent Application Publication No. WO 2017/172260.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:3. In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:4. In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO. 1997.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:3; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:4. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 3P10 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1997.

In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in any one of SEQ ID NOs:1978-1988. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982.

In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in any one of SEQ ID NOs:1990-2000. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in SEQ ID NO:1997.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in any one of SEQ ID NOs:1978-1988; and (ii) a VL comprising the amino acid sequence set forth in any one of SEQ ID NOs:1990-2000. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in SEQ ID NO: 1982; and (ii) a VL comprising the amino acid sequence set forth in SEQ ID NO:1997.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 5F12 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:7.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 2I23 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 21.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 6N16 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 23.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 1B3 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 25.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 6G9 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 37.

In some instances, the anti-GFRAL antibody comprises a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 2B11 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 39.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 5F12 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:8.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 2I23 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 22.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 6N16 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 24.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 1B3 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 26.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 6G9 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 38.

In some instances, the anti-GFRAL antibody comprises a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 2B11 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 40.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 5F12 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:7; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 5F12 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO:8.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 2I23 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 21; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 2I23 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 22.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 6N16 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 23; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 6N16 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 24.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 1B3 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 25; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 1B3 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 26.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 6G9 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 37; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 6G9 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 38.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of antibody 2B11 (or a humanized version thereof), and wherein the VH comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 39; and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of antibody 2B11 (or a humanized version thereof), and wherein the VL comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99% identity to the amino acid sequence set forth in SEQ ID NO: 40.

In some instances, the anti-GFRAL antibody comprises a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO:7. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in any one of SEQ ID NOs:1958-1965.

In some instances, the anti-GFRAL antibody comprises a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO:21.

In some instances, the anti-GFRAL antibody comprises a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 23.

In some instances, the anti-GFRAL antibody comprises a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 25.

In some instances, the anti-GFRAL antibody comprises a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 37.

In some instances, the anti-GFRAL antibody comprises a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 39.

In some instances, the anti-GFRAL antibody comprises a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO:8. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in any one of SEQ ID NOs:1967-1976.

In some instances, the anti-GFRAL antibody comprises a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 22.

In some instances, the anti-GFRAL antibody comprises a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 24.

In some instances, the anti-GFRAL antibody comprises a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 26.

In some instances, the anti-GFRAL antibody comprises a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 38.

In some instances, the anti-GFRAL antibody comprises a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 40.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO:7; and (ii) a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO:8. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in any one of SEQ ID NOs:1958-1965; and (ii) a VL comprising the amino acid sequence set forth in any one of SEQ ID NOs:1967-1976.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 21; and (ii) a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO:22.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 23; and (ii) a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 24.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 25; and (ii) a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 26.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 37; and (ii) a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 38.

In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 39; and (ii) a VL comprising a humanized version of the amino acid sequence set forth in SEQ ID NO: 40.

In some instances, the anti-GFRAL antibody comprises a heavy chain comprising a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 1982, and wherein the heavy chain comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010.

In some instances, the anti-GFRAL antibody comprises a light chain comprising a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:1997, and wherein the light chain comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012.

In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 from the amino acid sequence set forth in SEQ ID NO: 1982, and wherein the heavy chain comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:1997, and wherein the light chain comprises an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012.

In some instances, the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010.

In some instances, the anti-GFRAL antibody comprises a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012.

In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012.

In certain instances, the anti-GFRAL antibody is an antibody described in International Patent Application Publication No. WO 2017/172260, which is incorporated by reference herein in its entirety. In certain instances, the anti-GFRAL antibody is a humanized version of an antibody described in International Patent Application Publication No. WO 2017/172260, which is incorporated by reference herein in its entirety.

In some instances, the anti-GFRAL antibody binds to the same epitope as an antibody having the VH and VL of any one of Tables 1-7. In some instances, the anti-GFRAL antibody binds to the same epitope as antibody Hz3P10 (see Table 1A).

In some instances, the anti-GFRAL antibody specifically binds to human GFRAL within amino acid residues 220-316 of the amino acid sequence set forth in SEQ ID NO: 1797. In some instances, the anti-GFRAL antibody specifically binds to human GFRAL at one or more (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19) residues selected from the group consisting of. Met214, Pro216, Pro217, Gln290, Cys291, Thr292, Cys293, Arg294, Thr295, Ile296, Thr297, Gln298, Ser299, Glu301, Lys305, Gln308, His309, His312, and Ser315 of the amino acid sequence set forth in SEQ ID NO: 1797. In some instances, the anti-GFRAL antibody specifically binds to human GFRAL at Thr297. Gln298, and Ser299 of the amino acid sequence set forth in SEQ ID NO:1797.

In some instances, the anti-GFRAL antibody is a humanized antibody.

Various methods for generating humanized antibodies are known in the art. In some embodiments, a humanized antibody comprises one or more amino acid residues that have been introduced into it from a source that is non-human. In some embodiments, humanization is performed by substituting one or more non-human CDR sequences for the corresponding CDR sequences of a human antibody. In some embodiments, the humanized antibodies are constructed by substituting all six CDRs of a non-human antibody (e.g., a mouse antibody) for the corresponding CDRs of a human antibody.

The choice of which human heavy chain variable region and/or light chain variable region is used for generating humanized antibodies can be made based on a variety of factors and by a variety of methods known in the art. In some embodiments, the “best-fit” method is used where the sequence of the variable region of a non-human (e.g., rodent) antibody is screened against the entire library of known human variable region sequences. The human sequence that is most similar to that of the non-human (e.g., rodent) sequence is selected as the human variable region framework for the humanized antibody. In some embodiments, a particular variable region framework derived from a consensus sequence of all human antibodies of a particular subgroup of light or heavy chains is selected as the variable region framework. In some embodiments, the variable region framework sequence is derived from the consensus sequences of the most abundant human subclasses. In some embodiments, human germline genes are used as the source of the variable region framework sequences.

Other methods for humanization include, but are not limited to, a method called “superhumanization” which is described as the direct transfer of CDRs to a human germline framework, a method termed Human String Content (HSC) which is based on a metric of “antibody humanness”, methods based on generation of large libraries of humanized variants (including phage, ribosomal, and yeast display libraries), and methods based on framework region shuffling.

In some instances, the anti-GFRAL antibody is a human IgG1 antibody. In some instances, the anti-GFRAL antibody is a human IgG2 antibody. In some instances, the anti-GFRAL antibody is a human IgG4 antibody. In some instances, the anti-GFRAL antibody comprises a human kappa light chain constant region. In some instances, the anti-GFRAL antibody comprises a human lambda light chain constant region.

In some instances, the anti-GFRAL antibody is an antibody fragment comprising at least one antigen-binding site. In some embodiments, the antibody or antibody fragment is a Fab, Fab′, F(ab′)₂, Fv, scFv, (scFv)₂, single chain antibody, dual variable region antibody, single variable region antibody, linear antibody, diabody, nanobody, or a V region antibody.

The anti-GFRAL antibodies described herein can be produced by any suitable method known in the art. Such methods range from direct protein synthesis methods to constructing a DNA sequence encoding polypeptide sequences and expressing those sequences in a suitable host. See, e.g., International Patent Application Publication No. WO 2017/172260, which is incorporated by reference herein in its entirety, for a description of various methods for producing antibodies.

Also provided herein are pharmaceutical compositions comprising an anti-GFRAL antibody described herein. In some instances, the pharmaceutical composition comprises an anti-GFRAL antibody described herein and a pharmaceutically acceptable carrier. In some instances, the pharmaceutical composition comprises, an anti-GFRAL antibody comprising a VH comprising the VH CDR1, the VH CDR2, and the VH CDR3 of the antibody 3P10 or Hz3P10 (see Table 1 and Table 1A) and a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 of the antibody 3P10 or Hz3P10 (see Table 1 and Table 1A); and a pharmaceutically acceptable carrier. In some instances, the pharmaceutical composition comprises: an anti-GFRAL antibody comprising a VH comprising the amino acid sequence set forth in SEQ ID NO: 1982 and a VL comprising the amino acid sequence set forth in SEQ ID NO: 1997; and a pharmaceutically acceptable carrier. In some instances, the pharmaceutical composition comprises: an anti-GFRAL antibody comprising a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010 and a light comprising the amino acid sequence set forth in SEQ ID NO:2012; and a pharmaceutically acceptable carrier.

C. Paclitaxel

Paclitaxel (TAXOL) is an antimicrotubule agent indicated: (i) as first-line and subsequent therapy for the treatment of advanced carcinoma of the ovary, (ii) for the adjuvant treatment of node-positive breast cancer administered sequentially to standard doxorubicin-containing combination chemotherapy; (iii) for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy; (iv) in combination with cisplatin, for the first-line treatment of non-small cell lung cancer in patients who are not candidates for potentially curative surgery and/or radiation therapy; and (v) the second-line treatment of AIDS-related Kaposi's sarcoma.

The chemical name for paclitaxel is 5β,20-Epoxy-1,2α,4,7β,10β,13α-hexahydroxytax-11-en-9-one 4,10-diacetate 2-benzoate 13-ester with (2R,3S)—N-benzoyl-3-phenylisoserine.

Paclitaxel may be bound to protein (e.g., albumin). For instance, nanoparticle albumin-bound paclitaxel (referred to as “nab-paclitaxel”; ABRAXANE) is indicated for the treatment of: (i) metastatic breast cancer, after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy; (ii) locally advanced or metastatic non-small cell lung cancer (NSCLC), as first-line treatment in combination with carboplatin, in patients who are not candidates for curative surgery or radiation therapy; and (iii) metastatic adenocarcinoma of the pancreas as first-line treatment, in combination with gemcitabine.

In some instances, paclitaxel (e.g., nab-paclitaxel) is administered to a human patient at a dose of about 50 mg/m², about 60 mg/m², about 65 mg/m², about 70 mg/m², about 75 mg/m², about 80 mg/m², about 90 mg/m², about 95 mg/m², about 100 mg/m², about 115 mg/m², about 125 mg/m², about 135 mg/m², about 150 mg/m², 50-150 mg/m², 50-125 mg/m², 50-100 mg/m², 50-75 mg/m², 75-150 mg/m², 75-125 mg/m², 75-100 mg/m², or 100-125 mg/m². In some instances, paclitaxel (e.g., nab-paclitaxel) is administered to a human patient at a dose of 125 mg/m². In some instances, paclitaxel (e.g., nab-paclitaxel) is administered to a human patient at a dose of 125 mg/m²once a week. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the nab-paclitaxel is administered to a human patient at a dose of 125 mg/m². In some instances, the nab-paclitaxel is administered to a human patient at a dose of 125 mg/m²once a week for 3 weeks during a 4 week interval during which an anti-GFRAL antibody is administered to the human patient. In some instances, paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, paclitaxel (e.g., nab-paclitaxel) is administered to a human patient via intravenous infusion over 30-40 minutes on days 1, 8, and 15 during a 4 week interval during which an anti-GFRAL antibody is administered to the human patient.

D. Gemcitabine

Gemcitabine (GEMZAR) is a nucleoside metabolic inhibitor indicated: (i) in combination with carboplatin, for the treatment of advanced ovarian cancer that has relapsed at least 6 months after completion of platinum-based therapy; (ii) in combination with paclitaxel, for first-line treatment of metastatic breast cancer after failure of prior anthracycline-containing adjuvant chemotherapy, unless anthracyclines were clinically contraindicated, and (iii) in combination with cisplatin for the treatment of non-small cell lung cancer as a single agent for the treatment of pancreatic cancer.

The chemical name for gemcitabine is 4-amino-1-[(2R,4R,5R)-3,3-difluoro-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]pyrimidin-2-one.

In some instances, gemcitabine is administered to a human patient at a dose of about 400 mg/m², about 450 mg/m², about 500 mg/m², about 550 mg/m², about 600 mg/m², about 650 mg/m², about 700 mg/m², about 750 mg/m², about 800 mg/m², about 850 mg/m², about 900 mg/m², about 950 mg/m², about 1000 mg/m², 400-1000 mg/m², 400-800 mg/m², 400-600 mg/m², 500-1000 mg/m², 500-900 mg/m², 500-800 mg/m², or 500-700 mg/m². In some instances, gemcitabine is administered to a human patient at a dose of 1000 mg/m². In some instances, gemcitabine is administered to a human patient at a dose of 1000 mg/m²once a week for 3 weeks during a 4 week interval during which an anti-GFRAL antibody is administered to the human patient. In some instances, gemcitabine is administered to a human patient intravenously. In some instances, gemcitabine is administered to a human patient via intravenous infusion over 30-40 minutes on days 1, 8, and 15 during a 4 week interval during which an anti-GFRAL antibody is administered to the human patient.

E. Methods of Treatment

1. Methods of Treating a Cancer

An anti-GFRAL antibody described herein or a pharmaceutical composition comprising the same can be used to treat a human patient having a tumor (e.g., a tumor, an advanced solid tumor, a cancer).

Thus, provided herein is a method for treating a tumor (e.g., a tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody described herein at a dose of about 30 mg (or a pharmaceutical composition comprising the same) once about every 3 weeks. In some instances, the dose is 30 mg. In some instances, the dose is administered once every 3 weeks. In some instances, the dose is 30 mg and the dose is administered once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 30 mg about once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 30 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is an advanced solid tumor. In some instances, the cancer is a prostate cancer, a bladder cancer, a melanoma, a small cell lung cancer (SCLC) (including an extensive-stage SCLC), a non-small cell lung cancer (NSCLC), a pancreatic cancer, a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma, or an MSI-H (microsatellite instability high) cancer. The prostate cancer can include, for example, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a chemo-refractory prostate cancer, a prostate cancer where the patient has previously received one or more, two or more, or one or more (e.g., 1, 2, 3, or more) lines of standard prostate cancer therapies, or an advanced prostate cancer where the patient has exhausted all standard lines of therapies. A pancreatic cancer can include, for example, an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, or a metastatic pancreatic ductal adenocarcinoma. An MSI-H cancer can include, for example, an MSI-H prostate cancer, an MSI-H bladder cancer, an MSI-H melanoma, an MSI-H small cell lung cancer (SCLC) (including an extensive-stage SCLC), an MSI-H non-small cell lung cancer (NSCLC), an MSI-H pancreatic cancer, an MSI-H colorectal cancer, an MSI-H gastric cancer, an MSI-H esophageal cancer, an MSI-H ovarian cancer, or an MSI-H head and neck squamous cell carcinoma. In some instances, the patient has an elevated level of GDF15 in the serum compared to the baseline level of GDF15 thereof without the tumor. In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

Also provided herein is a method for treating a tumor (e.g., a solid tumor, an advanced solid tumor, a cancer) in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody described herein at a dose of about 100 mg (or a pharmaceutical composition comprising the same) once about every 3 weeks. In some instances, the dose is 100 mg. In some instances, the dose is administered once every 3 weeks. In some instances, the dose is 100 mg and the dose is administered once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 100 mg about once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 100 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is an advanced solid tumor. In some instances, the cancer is a prostate cancer, a bladder cancer, a melanoma, a small cell lung cancer (SCLC) (including an extensive-stage SCLC), a non-small cell lung cancer (NSCLC), a pancreatic cancer, a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma, or an MSI-H (microsatellite instability high) cancer. The prostate cancer can include, for example, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a chemo-refractory prostate cancer, a prostate cancer where the patient has previously received one or more, two or more, or one or more (e.g., 1, 2, 3, or more) lines of standard prostate cancer therapies, or an advanced prostate cancer where the patient has exhausted all standard lines of therapies. A pancreatic cancer can include, for example, an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, or a metastatic pancreatic ductal adenocarcinoma. An MSI-H cancer can include, for example, an MSI-H prostate cancer, an MSI-H bladder cancer, an MSI-H melanoma, an MSI-H small cell lung cancer (SCLC) (including an extensive-stage SCLC), an MSI-H non-small cell lung cancer (NSCLC), an MSI-H pancreatic cancer, an MSI-H colorectal cancer, an MSI-H gastric cancer, an MSI-H esophageal cancer, an MSI-H ovarian cancer, or an MSI-H head and neck squamous cell carcinoma. In some instances, the patient has an elevated level of GDF15 in the serum compared to the baseline level of GDF15 thereof without the tumor. In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In some cases, the human patient has an elevated serum level of GDF15 prior to the administering of the anti-GFRAL antibody compared to the serum level of GDF15 in said human prior to developing the cancer. In some instances, the human patient has an elevated level of GDF15 prior to the administering of the anti-GFRAL antibody. In some instances, the elevated level of GDF15 is an elevated level of circulating GDF15. In some instances, the elevated level of GDF15 is an elevated level of serum GDF15. In some cases, the elevated level of GDF15 is in the cancer tissue relative to the same non-cancerous tissue (e.g., in a cancerous prostate tissue relative to a non-cancerous prostate tissue). In some instances, the elevated level of GDF15 is as compared to a level of GDF15 in a human not having the cancer or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the cancer. In some instances, the human patient has a level of GDF15 that is at least 500 pg/mL (e.g., at least 500 pg/mL, at least 550 pg/mL, at least 600 pg/mL, at least 650 pg/mL, at least 700 pg/mL, at least 750 pg/mL, at least 800 pg/mL, at least 850 pg·mL, at least 900 pg/mL, at least 950 pg/mL, at least 1000 pg/mL, at least 1100 pg/mL, at least 1200 pg/mL, at least 1290 pg/mL, at least 1300 pg/mL, at least 1400 pg/mL, at least 1500 pg/mL, at least 1600 pg/mL, at least 1700 pg/mL, at least 1800 pg/mL, at least 1900 pg/mL, at least 2000 pg/mL, at least 3000 pg/mL, at least 4,000 pg/mL, at least 5,000 pg/mL, at least 10,000 pg/mL, at least 20,000 pg/mL, at least 30,000 pg/mL, at least 40,000 pg/mL, at least 50,000 pg/mL). In some instances, the human patient has a level of GDF between 1,000 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 500 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 800 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1000 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,100 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,300 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,500 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 50,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 40,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 30,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 20,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 10,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 5,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 3,000 pg/mL, inclusive. In some instances, the human patient has a serum GDF15 level of at least 950 pg/ml. In some instances, the human patient has a serum GDF15 level of at least 1300 pg/ml. In some instances, the level of GDF15 is a level of circulating GDF15. In some instances, the level of GDF15 is a level of serum GDF15.

In some instances, the patient is selected for treatment has elevated serum level of GDF15 in comparison with his or her own level before developing the cancer.

In some instances, the human patient has a reduced serum GDF15 level after the administering of the anti-GFRAL antibody as compared to the serum GDF15 level in the human patient prior to the administering of the anti-GFRAL antibody. In some instances, the method reduces the level of GDF15 (e.g., the level of GDF15 is decreased by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or more weeks of being administered 1, 2, 3, 4, 5, 6, or more doses of the anti-GFRAL antibody) compared to the level of GDF15 before being administered the anti-GFRAL antibody. Thus, in some instances, the level of GDF15 may be determined in a method of assessing effectiveness of administering the anti-GFRAL antibody to treat a human patient having cancer. In some instances, the level of GDF15 is a blood level of GDF15. In some instances, the level of GDF15 is a serum level of GDF15.

In some instances, the method further comprises determining a first level of GDF15. In some instances, the determining of a first level of GDF15 is before administering a first dose of the anti-GFRAL antibody. In some instances, the first level of GDF15 is a blood level of GDF15. In some instances, the first level of GDF15 is a serum level of GDF15. In some instances, the method further comprises determining a second level of GDF15 after administering the anti-GFRAL antibody. In some instances, the second level of GDF15 is a blood level of GDF15. In some instances, the second level of GDF15 is a serum level of GDF15. In some instances, the determining of the second level of GDF15 is after 2, 3, 4, 5, 6, 7, 8, 9, 10, or more doses of the anti-GFRAL antibody are administered to the human subject. In some instances, the second level of GDF15 is at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% less than the first level of GDF15.

In some instances, the method for treating the tumor stabilizes progression of the tumor. In some instances, the method for treating the cancer slows down progression of the tumor. In some instances, the method for treating the tumor halts progression of the cancer. In some instances, the method for treating the tumor shrinks a tumor size. In some instances, the method for treating the tumor increases overall survival of the patient. Methods for assessing the progression of a cancer are known in the art and include, e.g., evaluation of target lesions (e.g., measurement of tumor or lesion, using, e.g., X-ray, computerized tomography scan, magnetic resonance imaging, caliper measurement, or positron emission tomography scan), cytology or histology, or evaluation of tumor marker(s) (see, e.g., Eisenhauer et al., 2009, European Journal of Cancer 45:228-247 and Schwartz et al., 2016, European Journal of Cancer 62:132-137; each of which is incorporated by reference herein in its entirety).

In some instances, the human patient has tumor-related weight loss. In some instances, the method reduces tumor-related weight loss (e.g., the human patient loses less than 5%, less than 10%, less than 15%, less than 20%, less than 25%, less than 30%, less than 40%, or less than 50%, or does not lose more than 5%, more than 10%, more than 15%, more than 20%, more than 25%, more than 30%, more than 40%, or more than 50% of weight after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more weeks of being administered 1, 2, 3, 4, 5, or more doses of the anti-GFRAL antibody)). In some instances, the method increases lean body mass in the human patient (e.g., the human patient has an increase of at least 1%, at least 2%, at least 3%, at least 4%, at least 5%, at least 6%, at least 7%, at least 10%, at least 15%, at least 20%, at least 25%, 1-5%, 1-10%, 1-15%, 1-20%, 1-25%, 2-5%, 2-10%, 2-15%, 2-20%, 3-5%, 3-10%, 3-15%, 3-20%, 3-25%, 4-5%, 4-10%, 4-15%, 4-20%, 4-25%, 4-5%, 5-10%, 5-15%, 5-20%, 5-25%, 6-10%, 6-15%, 6-20%, 6-25%, 7-10%, 7-15%, 7-20%, 7-25%, 8-10%, 8-15%, 8-20%, 8-25%, 10-15%, 10-20%, 10-25%, 15-20%, 15-25%, 20%-25% of lean body mass after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more weeks of being administered 1, 2, 3, 4, 5, or more doses of the anti-GFRAL antibody)).

In some instances, the human patient has tumor-related cachexia. Cachexia is a wasting syndrome that is marked with loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite in someone who is not actively trying to lose weight. Cachexia can greatly contribute to morbidity of patients suffering from some chronic diseases (e.g., cancer, chronic renal disease, chronic inflammatory disease, muscle wasting, such as muscular dystrophy, and anorexia nervosa). For example, in late stage cancer, cachexia is common (occurring in most terminally ill cancer patients), and is responsible for about a quarter of all cancer-related deaths. In some instances, the method of treating the tumor reduces one or more (e.g., 1, 2, 3, 4, 5) symptoms of cachexia. Reduction of cachexia may be measured by, e.g., evaluating weight loss, muscle atrophy, fatigue, weakness, or appetite.

In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with one other cancer therapy prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with two other cancer therapies prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with three other cancer therapies prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some cases, the human patient has castration-resistant prostate cancer, and has received one or more lines of hormone therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient has castration-resistant prostate cancer and previously failed after one or more lines of hormone therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

Standard therapies for prostate cancer are known in the art. Non-limiting examples of standard therapy for prostate cancer include surgery, androgen-deprivation therapy, abiraterone, abiraterone acetate, apalutamide, bicalutamide, cabazitaxel, bicalutamide, darolutamide, degarelix, docetaxel, leuprolide acetate (LUPRON), enzalutamide, apalutamide, degarelix, flutamide, goserelin acetate, cabazitaxel, lutetium Lu 177 vipivotide tetraxetan, olaparib, mitoxantrone, mitoxantrone hydrochloride, nilutamide, relugolix, sipuleucel-t, radium 223, radium 223 dichloride, rucaparib camsylate, goserelin acetate, zoledronic acid (ZOMETA, and Oxaliplatin and pemetrexed.

In some instances in which the cancer is prostate cancer (e.g., an mCRPC, a castration-resistant prostate cancer tumor, a metastatic castrate-resistant, chemo-refractory prostate cancer, an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer) the cancer is PSA positive and the method reduces the level of PSA (e.g., the level of PSA is decreased by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or more weeks of being administered 1, 2, 3, 4, 5, 6, or more doses of the anti-GFRAL antibody) compared to the level of PSA before being administered the anti-GFRAL antibody. Thus, in some instances, the level of PSA may be determined in a method of assessing effectiveness of administering the anti-GFRAL antibody to treat a human patient having prostate cancer (e.g., an mCRPC, a castration-resistant prostate cancer tumor, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the level of PSA is a blood level of PSA. In some instances, the level of PSA is a serum level of PSA.

In some instances in which the cancer is prostate cancer (e.g., an mCRPC, a castration-resistant prostate cancer tumor, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), the method further comprises determining a first level of PSA. In some instances, the determining of a first level of PSA is before administering a first dose of the anti-GFRAL antibody. In some instances, the first level of PSA is a blood level of PSA. In some instances, the first level of PSA is a serum level of PSA. In some instances, the method further comprises determining a second level of PSA after administering the anti-GFRAL antibody. In some instances, the second level of PSA is a blood level of PSA. In some instances, the second level of PSA is a serum level of PSA. In some instances, the determining of the second level of PSA is after 2, 3, 4, 5, 6, 7, 8, 9, 10, or more doses of the anti-GFRAL antibody are administered to the human subject. In some instances, the second level of PSA is at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% less than the first level of PSA.

In some instances in which the cancer is a prostate cancer, administering of the anti-GFRAL antibody is in combination with one or more (e.g., 1, 2, 3, or more) anti-prostate cancer therapies (e.g., a chemotherapy, a radiation therapy, a hormonal therapy, or a surgical therapy). In some instances, the anti-prostate cancer therapy is surgery. In some instances, the anti-prostate cancer therapy is a radiation therapy. In some instances, the anti-prostate cancer therapy is androgen-deprivation therapy. In some instances, the anti-prostate cancer is a chemotherapy. In some instances, the anti-GFRAL antibody is administered prior to the anti-prostate cancer therapy (e.g., within 1 week, within 1 month, within 2 months, within 3 months, within 6 months prior to the anti-prostate cancer therapy). In some instances, the anti-GFRAL antibody is administered after the anti-prostate cancer therapy (e.g., within 1 week, within 1 month, within 2 months, within 3 months, within 6 months after the anti-prostate cancer therapy). In some instances, the anti-GFRAL antibody is administered simultaneously with the anti-prostate cancer therapy (e.g., within one day). In some instances, the anti-GFRAL antibody is administered after androgen-deprivation therapy. In some instances, the anti-GFRAL antibody is administered before chemotherapy.

In some instances, the anti-GFRAL antibody is a first-line treatment. In some instances, the human patient has not previously been treated with any other cancer therapy (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient has previously received one or more (e.g., 1, 2, 3, or more) anti-cancer therapies prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient is receiving a concomitant anti-cancer therapy. In some instances, the method further comprises administering to the human patient an anti-cancer therapy. In some instances, the anti-cancer therapy is a standard of care anti-cancer therapy for the tumor (e.g., cancer) being treated. In certain cases, the anti-cancer therapy is a chemotherapy, a radiation therapy, a hormonal therapy, or a surgical therapy.

In some instances, the human patient is about 35 years of age, about 40 years of age, about 45 years of age, about 50 years of age, about 55 years of age, about 60 years of age, about 65 years of age, about 70 years of age, about 75 years of age, about 80 years of age, or about 85 years of age. In some instances, the human patient is at least 35 years of age, at least 40 years of age, at least 45 years of age, at least 50 years of age, at least 55 years of age, at least 60 years of age, at least 65 years of age, at least 70 years of age, at least 75 years of age, at least 80 years of age, or at least 85 years of age. In some instances, the human patient is 35-90 years of age, 35-80 years of age, 35-70 years of age, 45-90 years of age, 45-80 years of age, 45-70 years of age, 55-90 years of age, 55-80 years of age, 55 to 75 years of age, or 55-65 years of age.

In some instances, the human patient is administered at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody.

In some instances, each of the at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody is about 30 mg and is administered about 3 weeks apart (i.e., once about every 3 weeks). In some instances, each of the doses of the anti-GFRAL antibody is 30 mg and is administered 3 weeks apart (i.e., once every 3 weeks). In some instances, each of the at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody is about 100 mg and is administered about 3 weeks apart (i.e., once about every 3 weeks). In some instances, each of the doses of the anti-GFRAL antibody is 100 mg and is administered 3 weeks apart (i.e., once every 3 weeks).

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:3 or 1982; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:4 or 1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225, and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 9(0%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO: 1982. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the dose of the anti-GFRAL antibody is about 30 mg. In some instances, the dose of the anti-GFRAL antibody is 30 mg. In some instances, the dose of the anti-GFRAL antibody is about 100 mg. In some instances, the dose of the anti-GFRAL antibody is 100 mg. In some instances, the dose of the anti-GFRAL antibody is administered once about every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is administered once every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is about 30 mg administered once about every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is 30 mg administered once every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is about 100 mg administered once about every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is 100 mg administered once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 30 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 100 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma tumor or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the human patient has castration-resistant prostate cancer. In some instances, the human patient has castration-resistant prostate cancer and previously failed after one or more lines of hormone therapies. In some cases, the human patient has an advanced prostate cancer (e.g., castration-resistant prostate cancer) and the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone. Oxaliplatin and pemetrexed).

In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered intravenously.

2. Methods of Treating Tumor-Related Weight Loss or Cachexia

An anti-GFRAL antibody described herein or a pharmaceutical composition comprising the same can also be used to treat a human patient having tumor-related weight loss or cachexia.

Thus, provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, the method comprising administering to the human patient an anti-GFRAL antibody described herein at a dose of about 30 mg (or a pharmaceutical composition comprising the same) once about every 3 weeks. In some instances, the method is for treating tumor-related weight loss. In some instances, the method is for treating tumor-related cachexia. In some instances, the dose is 30 mg. In some instances, the dose is administered once every 3 weeks. In some instances, the dose is 30 mg and the dose is administered once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 30 mg once about every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 30 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered intravenously.

Also provided herein is a method for treating tumor-related weight loss or cachexia in a human patient, comprising administering to the human patient an anti-GFRAL antibody described herein at a dose of about 100 mg (or a pharmaceutical composition comprising the same) once about every 3 weeks. In some instances, the method is for treating tumor-related weight loss. In some instances, the method is for treating tumor-related cachexia. In some instances, the dose is 100 mg. In some instances, the dose is administered once every 3 weeks. In some instances, the dose is 100 mg and the dose is administered once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 100 mg once about every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 100 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered intravenously.

In some cases, the human patient has an elevated serum level of GDF15 prior to the administering of the anti-GFRAL antibody compared to the serum level of GDF15 in said human prior to developing the cancer. In some instances, the human patient has an elevated level of GDF15 prior to the administering of the anti-GFRAL antibody. In some instances, the elevated level of GDF15 is an elevated level of circulating GDF15. In some instances, the elevated level of GDF15 is an elevated level of serum GDF15. In some cases, the elevated level of GDF15 is in the cancer tissue relative to the same non-cancerous tissue (e.g., in a cancerous prostate tissue relative to a non-cancerous prostate tissue). In some instances, the elevated level of GDF15 is as compared to a level of GDF15 in a human not having a cancer or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having a cancer. In some instances, the human patient has a level of GDF15 that is at least 500 pg/mL (e.g., at least 500 pg/mL, at least 550 pg/mL, at least 600 pg/mL, at least 650 pg/mL, at least 700 pg/mL, at least 750 pg/mL, at least 800 pg/mL, at least 850 pg·mL, at least 900 pg/mL, at least 950 pg/mL, at least 1000 pg/mL, at least 1100 pg/mL, at least 1200 pg/mL, at least 1290 pg/mL, at least 1300 pg/mL, at least 1400 pg/mL, at least 1500 pg/mL, at least 1600 pg/mL, at least 1700 pg/mL, at least 1800 pg/mL, at least 1900 pg/mL, at least 2000 pg/mL, at least 3000 pg/mL, at least 4,000 pg/mL, at least 5,000 pg/mL, at least 10,000 pg/mL, at least 20,000 pg/mL, at least 30,000 pg/mL, at least 40,000 pg/mL, at least 50,000 pg/mL). In some instances, the human patient has a level of GDF between 1,000 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 500 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 800 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1000 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,100 and 60.000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,300 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,500 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 50,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 40,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 30,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 20,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 10,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 5,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 3,000 pg/mL, inclusive. In some instances, the human patient has a serum GDF15 level of at least 950 pg/ml. In some instances, the human patient has a serum GDF15 level of at least 1300 pg/ml. In some instances, the level of GDF15 is a level of circulating GDF15. In some instances, the level of GDF15 is a level of serum GDF15. In some instances, the human patient has a reduced serum GDF15 level after the administering of the anti-GFRAL antibody as compared to the serum GDF15 level in the human patient prior to the administering of the anti-GFRAL antibody.

In some instances, the patient is selected for treatment has elevated serum level of GDF15 in comparison with his or her own level before developing the cancer.

In some instances, the method is for treating tumor-related weight loss. In some instances, the method reduces tumor-related weight loss (e.g., the human patient loses less than 5%, less than 10%, less than 15%, less than 20%, less than 25%, less than 30%, less than 40%, or less than 50%, or does not lose more than 5%, more than 10%, more than 15%, more than 20%, more than 25%, more than 30%, more than 40%, or more than 50% of weight after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more weeks of being administered 2, 3, 4, 5, or more doses of the anti-GFRAL antibody)). In some instances, the method increases lean body mass in the human patient (e.g., the human patient has an increase of at least 1%, at least 2%, at least 3%, at least 4%, at least 5%, at least 6%, at least 7%, at least 10%, at least 15%, at least 20%, at least 25%, 1-5%, 1-10%, 1-15%, 1-20%, 1-25%, 2-5%, 2-10%, 2-15%, 2-20%, 3-5%, 3-10%, 3-15%, 3-20%, 3-25%, 4-5%, 4-10%, 4-15%, 4-20%, 4-25%, 4-5%, 5-10%, 5-15%, 5-20%, 5-25%, 6-10%, 6-15%, 6-20%, 6-25%, 7-10%, 7-15%, 7-20%, 7-25%, 8-10%, 8-15%, 8-20%, 8-25%, 10-15%, 10-20%, 10-25%, 15%-20%, 15-25%, 20%-25% of lean body mass after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more weeks of being administered 1, 2, 3, 4, 5, or more doses of the anti-GFRAL antibody)). In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In some instances, method is for treating tumor-related cachexia. In some instances, the method reduces one or more (e.g., 1, 2, 3, 4, 5) symptoms of cachexia. Reduction of cachexia may be measured by, e.g., evaluating weight loss, muscle atrophy, fatigue, weakness, or appetite in a human patient.

In some instances, the human patient has a cancer. In some instances, the cancer is a solid tumor cancer. In some instances, the cancer is an advanced cancer. In some instances, the cancer is an advanced solid tumor. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant, chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a chemo-refractory prostate cancer; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer (e.g., castration-resistant prostate cancer), wherein the human patient has previously received one or more (e.g., 1, 2, 3, or more) lines of therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed).

In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, or more) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with one other cancer therapy prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with two other cancer therapies prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with three other cancer therapies prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient has castration-resistant prostate cancer and previously failed or relapsed after one or more lines of hormone therapies. In some cases, the human patient has an advanced prostate cancer (e.g., castration-resistant prostate cancer) and the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone, Oxaliplatin and pemetrexed). In some instances, the human patient previously failed to be treated with or relapsed from one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient has previously received one or more (e.g., 1, 2, 3, or more) anti-cancer therapies prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient is receiving a concomitant anti-cancer therapy. In some instances, the method further comprises administering to the human patient an anti-cancer therapy. In certain cases, the anti-cancer therapy is a chemotherapy, a radiation therapy, a hormonal therapy, or a surgical therapy.

In some instances, the human patient is administered at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody.

In some instances, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:3 or 1982, and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:4 or 1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in SEQ ID NO: 1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising the amino acid sequence set forth in SEQ ID NO: 1997. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the dose of the anti-GFRAL antibody is about 30 mg. In some instances, the dose of the anti-GFRAL antibody is 30 mg. In some instances, the dose of the anti-GFRAL antibody is about 100 mg. In some instances, the dose of the anti-GFRAL antibody is 100 mg. In some instances, the dose of the anti-GFRAL antibody is administered once about every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is administered once every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is about 30 mg administered once about every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is 30 mg administered once every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is about 100 mg administered once about every 3 weeks. In some instances, the dose of the anti-GFRAL antibody is 100 mg administered once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 30 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 100 mg once every 3 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the tumor is a solid tumor. In some instances, the tumor is an advanced solid tumor. In some instances, the tumor is a cancer. In some instances, the cancer is metastatic. In some instances, the cancer is advanced. In some instances, the cancer is a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castration-resistant prostate cancer, a chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a metastatic chemo-refractory prostate cancer), a bladder cancer, a melanoma, an SCLC (e.g., an extensive-stage SCLC), an NSCLC, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head neck squamous cell carcinoma or an MSI-H cancer (e.g., an MSI-H prostate cancer, an MSI-H pancreatic cancer, an MSI-H ovarian cancer, an MSI-H ovarian cancer, an MSI-H HNSCC, an MSI-H SLCLC (e.g., an MSI-H extensive-stage SCLC). In some instances, the cancer is an MSI-H cancer selected from a castration-resistant prostate cancer, a bladder cancer, a melanoma, a SCLC (e.g., an extensive-stage SCLC), a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), a colorectal cancer, a gastric cancer, an esophageal cancer, an ovarian cancer, a head and neck squamous cell carcinoma). In some instances, the cancer is a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the cancer is a pancreatic adenocarcinoma. In some instances, the cancer is a metastatic pancreatic cancer. In some instances, the cancer is a metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an advanced pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma. In some instances, the human patient has a prostate cancer (e.g., an mCRPC, a castration-sensitive prostate cancer, a castration-resistant prostate cancer, an MSI-H prostate cancer, a metastatic prostate cancer, a metastatic castrate-resistant prostate cancer, a chemo-refractory prostate cancer; an advanced prostate cancer where the patient has exhausted all standard therapies with elevated baseline serum GDF15; an advanced prostate cancer where the patient has previously received one or more (e.g., 1, 2, 3, or more) lines of cancer therapies; a metastatic chemo-refractory prostate cancer). In some instances, the cancer is advanced prostate cancer. In some instances, the human patient has prostate cancer and poor survival. In some instances, the cancer is an mCRPC. In some instances, the cancer is chemo-refractory prostate cancer. In some instances, the cancer is metastatic chemo-refractory prostate cancer. In some instances, the cancer is metastatic castrate-resistant, chemo-refractory prostate cancer. In some instances, the cancer is advanced prostate cancer, wherein the human patient has exhausted all standard therapies, and wherein the human patient has an elevated baseline serum GDF15 (compared to a human or a panel of humans not having prostate cancer). In some instances, the cancer is advanced prostate cancer, wherein the human patient has previously received more than one line of therapies. In some instances, the cancer is advanced prostate cancer, wherein the human patient has previously received more than two lines of therapies. In some instances, the cancer is advanced prostate cancer, wherein the human patient has previously received more than three linel of therapies. In some instances, the cancer is advanced prostate cancer, wherein the human patient has relapsed from one or more lines of previous therapies. The one or more lines of therapies can include surgery, radiation, androgen-deprivation therapy or a chemotherapy (e.g., leuprolide acetate (LUPRON), zoledronic acid (ZOMETA), docetaxel, cabazitaxel, radium 223, mitoxantrone. Oxaliplatin and pemetrexed).

In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered intravenously.

3. Methods of Treating Pancreatic Cancer

An anti-GFRAL antibody described herein or a pharmaceutical composition comprising the same can also be used to treat a human patient having pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma), in combination with paclitaxel (e.g., nab-paclitaxel) and gemcitabine.

Thus, provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, the method comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of about 30 mg (or a pharmaceutical composition comprising the same) once about every 4 weeks, wherein the anti-GFRAL antibody inhibits GFRAL binding to RET; (b) paclitaxel (e.g., nab-paclitaxel); and (c) gemcitabine. In some instances, the dose is 30 mg. In some instances, the dose is administered once every 4 weeks. In some instances, the dose is 30 mg and the dose is administered once every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 30 mg once about every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 30 mg once every 4 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

Thus, provided herein is a method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) in a human patient, comprising administering to the human patient: (a) an anti-GFRAL antibody at a dose of about 100 mg (or a pharmaceutical composition comprising the same) once about every 4 weeks, wherein the anti-GFRAL antibody inhibits GFRAL binding to RET; (b) paclitaxel (e.g., nab-paclitaxel); and (c) gemcitabine. In some instances, the dose is 100 mg. In some instances, the dose is administered once every 4 weeks. In some instances, the dose is 100 mg and the dose is administered once every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 100 mg once about every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 100 mg once every 4 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

In some instances, the human patient is administered at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, at least 15 doses, at least 20 doses, at least 30 doses, at least 40 doses, at least 50 doses, 1-50 doses, 10-50 doses, 10-40 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 or more doses of paclitaxel (e.g., nab-paclitaxel). In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient once a week, once every 2 weeks, once every 3 weeks, once every 4 weeks, once every 5 weeks, once every 6 weeks, once every 7 weeks, or once every 8 weeks. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient once a week. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient once every 2 weeks. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient once, twice, 3 times, 4 times, 5 times, 6 times, 7 times, or 8 times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. For instance, if the anti-GFRAL antibody is administered to the human patient once every 4 weeks, then the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient once, twice, 3 times, 4 times, 5 times, 6 times, 7 times, or 8 times in between two doses (4 weeks apart) of the anti-GFRAL antibody, inclusive. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient twice during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient 3 times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient 4 times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of about 50 mg/m², about 60 mg/m², about 65 mg/m², about 70 mg/m², about 75 mg/m², about 80 mg/m², about 90 mg/m², about 95 mg/m², about 100 mg/m², about 115 mg/m², about 125 mg/m², about 135 mg/m², about 150 mg/m², 50-150 mg/m², 50-125 mg/m², 50-100 mg/m², 50-75 mg/m², 75-150 mg/m², 75-125 mg/m², 75-100 mg/m², or 100-125 mg/m². In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m². In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient at a dose of 125 mg/m²once a week. In some instances, the paclitaxel is nab-paclitaxel. In some instances, the nab-paclitaxel is administered to the human patient at a dose of 125 mg/m². In some instances, the nab-paclitaxel is administered to the human patient at a dose of 125 mg/m²once a week for 3 weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient intravenously. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient via intravenous infusion over 30-40 minutes on days 1, 8, and 15 during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient.

In some instances, the human patient is administered at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, at least 15 doses, at least 20 doses, at least 30 doses, at least 40 doses, at least 50 doses, 1-50 doses, 10-50 doses, 10-40 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 or more of gemcitabine. In some instances, the gemcitabine is administered to the human patient once a week, once every 2 weeks, once every 3 weeks, once every 4 weeks, once every 5 weeks, once every 6 weeks, once every 7 weeks, or once every 8 weeks. In some instances, the gemcitabine is administered to the human patient once a week. In some instances, the gemcitabine is administered to the human patient once every 2 weeks. In some instances, the gemcitabine is administered to the human patient once, twice, 3 times, 4 times, 5 times, 6 times, 7 times, or 8 times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. For instance, if the anti-GFRAL antibody is administered to the human patient once every 4 weeks, then the gemcitabine is administered to the human patient once, twice, 3 times, 4 times, 5 times, 6 times, 7 times, or 8 times in between two doses (4 weeks apart) of the anti-GFRAL antibody, inclusive. In some instances, the gemcitabine is administered to the human patient twice during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient 3 times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient 4 times during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient at a dose of about 400 mg/m², about 450 mg/m², about 500 mg/m², about 550 mg/m², about 600 mg/m², about 650 mg/m², about 700 mg/m², about 750 mg/m², about 800 mg/m², about 850 mg/m², about 900 mg/m², about 950 mg/m², about 1000 mg/m², 400-1000 mg/m², 400-800 mg/m², 400-600 mg/m², 500-1000 mg/m², 500-900 mg/m², 500-800 mg/m², or 500-700 mg/m². In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m². In some instances, the gemcitabine is administered to the human patient at a dose of 1000 mg/m²once a week for 3 weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient intravenously. In some instances, the gemcitabine is administered to the human patient via intravenous infusion over 30-40 minutes on days 1, 8, and 15 during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient.

In some instances, the paclitaxel (e.g., nab-paclitaxel) and gemcitabine are administered to the human patient concurrently (or within 1 minute, within 2 minutes, within 5 minutes, within 10 minutes, or within 1 hour of each other). In some instances, the paclitaxel (e.g., nab-paclitaxel) and gemcitabine are administered to the human patient sequentially (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 13, 14, 15, 16, 17, 18, 19, 20, or 21 days of each other). In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient prior to (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or 21 days prior to) administering to the human patient the gemcitabine. In some instances, the gemcitabine is administered to the human patient prior to (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 13, 14, 15, 16, 17, 18, 19, 20, or 21 days prior to) administering to the human patient the paclitaxel (e.g., nab-paclitaxel). In some instances, the first dose of paclitaxel (e.g., nab-paclitaxel) and/or the gemcitabine is/are administered to the human patient prior to (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 13, 14, 15, 16, 17, 18, 19, 20, or 21 days prior to) administering to the human patient a first dose of the human patient the anti-GFRAL antibody. In some instances, the first dose of paclitaxel (e.g., nab-paclitaxel) and/or the gemcitabine is/are administered to the human patient after (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 13, 14, 15, 16, 17, 18, 19, 20, or 21 days after) administering to the human patient a first dose of the human patient the anti-GFRAL antibody. In some instances, the first dose of paclitaxel (e.g., nab-paclitaxel) and/or the gemcitabine is/are administered to the human patient concurrently (or within 1 minute, within 2 minutes, within 5 minutes, within 10 minutes, or within 1 hour of each other) with administering to the human patient a first dose of the human patient the anti-GFRAL antibody.

In some cases, the human patient has an elevated serum level of GDF15 prior to the administering of the anti-GFRAL antibody compared to the serum level of GDF15 in said human prior to developing the cancer. In some instances, the human patient has an elevated level of GDF15 prior to the administering of the anti-GFRAL antibody. In some instances, the elevated level of GDF15 is an elevated level of circulating GDF15. In some instances, the elevated level of GDF15 is an elevated level of serum GDF15. In some cases, the elevated level of GDF15 is in the cancer tissue relative to the same non-cancerous tissue (e.g., in a cancerous pancreatic tissue relative to a non-cancerous pancreatic tissue). In some instances, the elevated level of GDF15 is as compared to a level of GDF15 in a human not having the cancer or a panel of humans (e.g., 2, 3, 4, 5, 10, 15, 20, 25, or more) not having the cancer. In some instances, the human patient has a level of GDF15 that is at least 500 pg/mL (e.g., at least 500 pg/mL, at least 550 pg/mL, at least 600 pg/mL, at least 650 pg/mL, at least 700 pg/mL, at least 750 pg/mL, at least 800 pg/mL, at least 850 pg·mL, at least 900 pg/mL, at least 950 pg/mL, at least 1000 pg/mL, at least 1100 pg/mL, at least 1200 pg/mL, at least 1290 pg/mL, at least 1300 pg/mL, at least 1400 pg/mL, at least 1500 pg/mL, at least 1600 pg/mL, at least 1700 pg/mL, at least 1800 pg/mL, at least 1900 pg/mL, at least 2000 pg/mL, at least 3000 pg/mL, at least 4,000 pg/mL, at least 5,000 pg/mL, at least 10,000 pg/mL, at least 20,000 pg/mL, at least 30,000 pg/mL, at least 40,000 pg/mL, at least 50,000 pg/mL). In some instances, the human patient has a level of GDF between 1,000 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 500 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 800 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1000 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,100 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,300 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,500 and 60,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 50,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 40,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 30,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 20,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 10,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 5,000 pg/mL, inclusive. In some instances, the human patient has a level of GDF15 that is between 1,000 and 3,000 pg/mL, inclusive. In some instances, the human patient has a serum GDF15 level of at least 950 pg/ml. In some instances, the human patient has a serum GDF15 level of at least 1300 pg/ml. In some instances, the level of GDF15 is a level of circulating GDF15. In some instances, the level of GDF15 is a level of serum GDF15. In some instances, the human patient has a reduced serum GDF15 level after the administering of the anti-GFRAL antibody as compared to the serum GDF15 level in the human patient prior to the administering of the anti-GFRAL antibody.

In some instances, the patient is selected for treatment has elevated serum level of GDF15 in comparison with his or her own level before developing the cancer.

In some instances, the method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) stabilizes progression of the cancer. In some instances, the method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) slows down progression of the cancer. In some instances, the method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) halts progression of the cancer. In some instances, the method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) shrinks the size of a tumor of the cancer. In some instances, the method for treating pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) increases overall survival of the patient. Methods for assessing the progression of a cancer are known in the art and include, e.g., evaluation of target lesions (e.g., measurement of tumor or lesion, using, e.g., X-ray, computerized tomography scan, magnetic resonance imaging, caliper measurement, or positron emission tomography scan), cytology or histology, or evaluation of tumor marker(s) (see, e.g., Eisenhauer et al., 2009, European Journal of Cancer 45:228-247 and Schwartz et al., 2016, European Journal of Cancer 62:132-137; each of which is incorporated by reference herein in its entirety).

In some instances, the human patient has pancreatic tumor-related weight loss. In some instances, the method reduces pancreatic tumor-related weight loss (e.g., the human patient loses less than 5%, less than 10%, less than 15%, less than 20%, less than 25%, less than 30%, less than 40%, or less than 50%, or does not lose more than 5%, more than 10%, more than 15%, more than 20%, more than 25%, more than 30%, more than 40%, or more than 50% of weight after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more weeks of being administered 1, 2, 3, 4, 5, or more doses of the anti-GFRAL antibody)). In some instances, the method increases lean body mass in the human patient (e.g., the human patient has an increase of at least 1%, at least 2%, at least 3%, at least 4%, at least 5%, at least 6%, at least 7%, at least 10%, at least 15%, at least 20%, at least 25%, 1-5%, 1-10%, 1-15%, 1-20%, 1-25%, 2-5%, 2-10%, 2-15%, 2-20%, 3-5%, 3-10%, 3-15%, 3-20%, 3-25%, 4-5%, 4-10%, 4-15%, 4-20%, 4-25%, 4-5%, 5-10%, 5-15%, 5-20%, 5-25%, 6-10%, 6-15%, 6-20%, 6-25%, 7-10%, 7-15%, 7-20%, 7-25%, 8-10%, 8-15%, 8-20%, 8-25%, 10-15%, 10-20%, 10-25%, 15%-20%, 15-25%, 20%-25% of lean body mass after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or more weeks of being administered 1, 2, 3, 4, 5, or more doses of the anti-GFRAL antibody, paclitaxel, and gemcitabine)).

In some instances, the human patient has tumor-related cachexia. In some instances, the method reduces one or more (e.g., 1, 2, 3, 4, 5) symptoms of cachexia. Reduction of cachexia may be measured by, e.g., evaluating weight loss, muscle atrophy, fatigue, weakness, or appetite.

In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, or more) other cancer (e.g., pancreatic cancer, e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma.) therapies (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with one other cancer (e.g., pancreatic cancer, e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) therapy prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with two other cancer (e.g., pancreatic cancer, e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) therapies prior to the administering of the anti-GFRAL antibody. In some instances, the human patient previously failed to be treated with three other cancer (e.g., pancreatic cancer, e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) therapies prior to the administering of the anti-GFRAL antibody.

In some instances, the anti-GFRAL antibody is a first-line treatment. In some instances, the human patient has not previously been treated with any other cancer (e.g., pancreatic cancer, e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) therapy (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient has previously received one or more (e.g., 1, 2, 3, or more) anti-pancreatic cancer therapies prior to the administering of the anti-GFRAL antibody.

In some instances, the human patient is administered at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody.

In some instances, each of the at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more of the anti-GFRAL antibody is about 30 mg and is administered about 4 weeks apart (i.e., once about every 4 weeks). In some instances, each of the doses of the anti-GFRAL antibody is 30 mg and is administered 4 weeks apart (i.e., once every 4 weeks). In some instances, each of the at least 2, at least 3, at least 4, at least 5, at least 6, at least 7 at least 8, at least 9, at least 10 doses, at least 11 doses, at least 12 doses, or 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 or more doses of the anti-GFRAL antibody is about 100 mg and is administered about 4 weeks apart (i.e., once about every 4 weeks). In some instances, each of the doses of the anti-GFRAL antibody is 100 mg and is administered 4 weeks apart (i.e., once every 4 weeks).

In some instances in which the pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) is CA19-9-positive, the method reduces the level of CA19-9 (e.g., the level of CA19-9 is decreased by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or more weeks of being administered 1, 2, 3, 4, 5, 6, or more doses of the anti-GFRAL antibody) compared to the level of CA19-9 before being administered the anti-GFRAL antibody. Thus, in some instances, the level of CA19-9 may be determined in a method of assessing effectiveness of administering the anti-GFRAL antibody, paclitaxel (e.g., nab-paclitaxel), and gemcitabine to treat a human patient having pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma). In some instances, the level of CA19-9 is a blood level of CA19-9. In some instances, the level of CA19-9 is a serum level of CA19-9. In some instances, a pancreatic cancer (e.g., an advanced pancreatic cancer, a metastatic pancreatic cancer, a pancreatic adenocarcinoma, a metastatic pancreatic adenocarcinoma, an MSI-H pancreatic cancer, a pancreatic ductal adenocarcinoma, a metastatic pancreatic ductal adenocarcinoma) is CA19-9-positive if blood levels are greater than or equal to 37 U/mL.

In some instances, the method further comprises determining a first level of CA19-9. In some instances, the determining of a first level of CA19-9 is before administering a first dose of the anti-GFRAL antibody, before administering a first dose of paclitaxel (e.g., nab-paclitaxel), and before administering a first dose of gemcitabine. In some instances, the first level of CA19-9 is a blood level of CA19-9. In some instances, the first level of CA19-9 is a serum level of CA19-9. In some instances, the method further comprises determining a second level of CA19-9 after administering the anti-GFRAL antibody, paclitaxel (e.g., nab-paclitaxel), and gemcitabine. In some instances, the second level of CA19-9 is a blood level of CA19-9. In some instances, the second level of CA19-9 is a serum level of CA19-9. In some instances, the determining of the second level of CA19-9 is after 2, 3, 4, 5, 6, 7, 8, 9, 10, or more doses of the anti-GFRAL antibody are administered to the human subject. In some instances, the second level of CA19-9 is at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% less than the first level of CA19-9.

In some instances, the method reduces the level of GDF15 (e.g., the level of GDF15 is decreased by at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% after being administered the anti-GFRAL antibody (e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24 or more weeks of being administered 1, 2, 3, 4, 5, 6, or more doses of the anti-GFRAL antibody) compared to the level of GDF15 before being administered the anti-GFRAL antibody. Thus, in some instances, the level of GDF15 may be determined in a method of assessing effectiveness of administering the anti-GFRAL antibody to treat a human patient having cancer. In some instances, the level of GDF15 is a blood level of GDF15. In some instances, the level of GDF15 is a serum level of GDF15.

In some instances, the method of assessing effectiveness of administering the anti-GFRAL antibody to treat a human patient having cancer further comprises determining a first level of GDF15. In some instances, the determining of a first level of GDF15 is before administering a first dose of the anti-GFRAL antibody. In some instances, the first level of GDF15 is a blood level of GDF15. In some instances, the first level of GDF15 is a serum level of GDF15. In some instances, the method further comprises determining a second level of GDF15 after administering the anti-GFRAL antibody. In some instances, the second level of GDF15 is a blood level of GDF15. In some instances, the second level of GDF15 is a serum level of GDF15. In some instances, the determining of the second level of GDF15 is after 2, 3, 4, 5, 6, 7, 8, 9, 10, or more doses of the anti-GFRAL antibody are administered to the human subject. In some instances, the second level of GDF15 is at least 10%, at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 98%, 10-98%, 20-98%, 30-98%, 40-98%, 50-98%, 60-98%, 70-98%, 80-98%, or 90-98% less than the first level of GDF15.

In some instances of the combination therapy of the anti-GFRAL antibody, paclitaxel (e.g., nab-paclitaxel), and gemcitabine, the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:3 or 1982; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:4 or 1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90° %, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 10(0% identity to the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the dose of the anti-GFRAL antibody is about 30 mg. In some instances, the dose of the anti-GFRAL antibody is 30 mg. In some instances, the dose of the anti-GFRAL antibody is about 100 mg. In some instances, the dose of the anti-GFRAL antibody is 100 mg. In some instances, the dose of the anti-GFRAL antibody is administered once about every 4 weeks. In some instances, the dose of the anti-GFRAL antibody is administered once every 4 weeks. In some instances, the dose of the anti-GFRAL antibody is about 30 mg administered once about every 4 weeks. In some instances, the dose of the anti-GFRAL antibody is 30 mg administered once every 4 weeks. In some instances, the dose of the anti-GFRAL antibody is about 100 mg administered once about every 4 weeks. In some instances, the dose of the anti-GFRAL antibody is 100 mg administered once every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 30 mg once about every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 30 mg once every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of about 100 mg once about every 4 weeks. In some instances, the anti-GFRAL antibody is administered subcutaneously at a dose of 100 mg once every 4 weeks. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma

In some instances of the combination therapy of the anti-GFRAL antibody, paclitaxel (e.g., nab-paclitaxel), and gemcitabine, the anti-GFRAL antibody is administered to the human patient subcutaneously at a dose of 30 mg once every 4 weeks, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient via intravenous infusion (e.g., over 30-40 minutes) once every week for three weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient, and the gemcitabine is administered to the human patient via intravenous infusion (e.g., over 30-40 minutes) once every week for 3 weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient, wherein the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:3 or 1982; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:4 or 1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises; (i) a VH comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 9(0%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising the amino acid sequence set forth in SEQ ID NO: 1997. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient on days 1, 8, and 15 during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient on days 1, 8, and 15 during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the pancreatic cancer is advanced pancreatic cancer. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

In some instances of the combination therapy of the anti-GFRAL antibody, paclitaxel (e.g., nab-paclitaxel), and gemcitabine, the anti-GFRAL antibody is administered to the human patient subcutaneously at a dose of 100 mg once every 4 weeks, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient via intravenous infusion (e.g., over 30-40 minutes) once every week for three weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient, and the gemcitabine is administered to the human patient via intravenous infusion (e.g., over 30-40 minutes) once every week for 3 weeks during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient, wherein the anti-GFRAL antibody comprises (i) a VH comprising the VH CDR1, the VH CDR2, the VH CDR3 from the amino acid sequence set forth in SEQ ID NO:3 or 1982; and (ii) a VL comprising the VL CDR1, the VL CDR2, and the VL CDR3 from the amino acid sequence set forth in SEQ ID NO:4 or 1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:46, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO: 137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising a VH CDR1 comprising the amino acid sequence set forth in SEQ ID NO:48, a VH CDR2 comprising the amino acid sequence set forth in SEQ ID NO:137, and a VH CDR3 comprising the amino acid sequence set forth in SEQ ID NO:225; and (ii) a VL comprising a VL CDR1 comprising the amino acid sequence set forth in SEQ ID NO:301, a VL CDR2 comprising the amino acid sequence set forth in SEQ ID NO:376, and a VL CDR3 comprising the amino acid sequence set forth in SEQ ID NO:426. In some instances, the anti-GFRAL antibody comprises; (i) a VH comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a VH comprising the amino acid sequence set forth in SEQ ID NO:1982. In some instances, the anti-GFRAL antibody comprises a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises: (i) a VH comprising the amino acid sequence set forth in SEQ ID NO:1982; and (ii) a VL comprising the amino acid sequence set forth in SEQ ID NO:1997. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises; (i) a heavy chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising an amino acid sequence having at least at least 75%, at least 80%, at least 85%, at least 90%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, or 100% identity to the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010. In some instances, the anti-GFRAL antibody comprises a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises: (i) a heavy chain comprising the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain comprising the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the anti-GFRAL antibody comprises; (i) a heavy chain consisting of the amino acid sequence set forth in SEQ ID NO:2010; and (ii) a light chain consisting of the amino acid sequence set forth in SEQ ID NO:2012. In some instances, the paclitaxel (e.g., nab-paclitaxel) is administered to the human patient on days 1, 8, and 15 during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the gemcitabine is administered to the human patient on days 1, 8, and 15 during the 4 week interval during which the anti-GFRAL antibody is administered to the human patient. In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered intravenously. In some instances, the pancreatic cancer is advanced pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

In some instances, the human patient previously failed to be treated with one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies including any one of the standard of care therapies for a pancreatic cancer (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the human patient has relapsed from one or more (e.g., 1, 2, 3, 4, 5) other cancer therapies including any one of the standard of care therapies for a pancreatic cancer patient (i.e., other than an anti-GFRAL antibody described herein) prior to the administering of the anti-GFRAL antibody. In some instances, the pancreatic cancer is metastatic pancreatic cancer. In some instances, the pancreatic cancer is an MSI-H pancreatic cancer. In some instances, the pancreatic cancer is pancreatic adenocarcinoma. In some instances, the pancreatic cancer is metastatic pancreatic adenocarcinoma. In some instances, the pancreatic cancer is an MSI-H pancreatic adenocarcinoma. In some instances, the pancreatic cancer is a pancreatic ductal adenocarcinoma. In some instances, the pancreatic cancer is a metastatic pancreatic ductal adenocarcinoma.

In some instances, the anti-GFRAL antibody is administered subcutaneously. In some instances, the anti-GFRAL antibody is administered intravenously.

VIII. EXAMPLES
Example 1: Doses of an Anti-GFRAL Antibody Tested in Animal Model

In order to ascertain the effective dose(s) of an anti-GFRAL antibody as a therapy, a wide range of doses were first tested in an animal model. In this model, rats were administered with cisplatin to induced body weight loss, and the effect of various doses of an anti-GFRAL antibody on preventing or reducing the body weight loss of the rats were assessed. Briefly, rats were administered subcutaneously with a humanized anti-GFRAL antibody 3P10 (comprising a heavy chain of SEQ ID NO:2010, and a light chain of SEQ ID NO:2012) at a dose of 0.3 mg/kg, 1.0 mg/kg, 3.0 mg/kg, or 10 mg/kg once per week for 3 weeks. 24 hours after each administration, the rats were administered subcutaneously with cisplatin at 4 mg/kg. Body weight was determined for each animal (n=8 per group) every 24 hours during the 21-day treatment. Day 0 measurement was performed 24 hours after the first administration of the anti-GFRAL antibody and before the first administration of cisplatin.

As shown in FIG. 1, the rats in the control group (Group 1) that received PBS instead of cisplatin and the anti-GFRAL antibody gained weight throughout the experiment with an average increase in weight of 33% (from 205 f 2 g to 306 t 3 g) from day 0 to day 21. In contrast, the rats that received cisplatin only (Group 2) increased weight by an average of only 13% (from 205 t 3 g to 237 f 18 g) day 0 to day 21, 0.3 mg/kg of the anti-GFRAL antibody (in Group 3 rats) did not prevent the cisplatin-induced weight loss in rats significantly. However, 1.0 mg/kg, 3.0 mg/kg and 10 mg/kg of the anti-GFRAL antibody reduced the cisplatin-induced weight loss significantly and to a similar extent. These results suggest that 1.0 mg/kg, 3.0 mg/kg and 10 mg/kg of the anti-GFRAL antibody worked at a similar efficacy in rats.

The dose-response relationship for the anti-GFRAL antibody on food intake was also measured (data not shown), and the results are consistent with the observed reduction of body weight loss in the cisplatin-treated rats, confirming that 1.0 mg/kg, 3.0 mg/kg and 10 mg/kg of the anti-GFRAL antibody work at a similar efficacy in an animal model.

Example 2: Doses of an Anti-GFRAL Antibody Tested in Human

Based on the effective doses of the anti-GFRAL antibody determined from the rat model as described in Example 1, a roughly corresponding range of doses of the anti-GFRAL antibody for human was tested.

Healthy human volunteers were administered subcutaneously with the humanized anti-GFRAL antibody 3P10 (comprising a heavy chain of SEQ ID NO:2010, and a light chain of SEQ ID NO:2012) at a dose of 10 mg, 30 mg, 100 mg or 200 mg once every four weeks for 12 weeks. The body weight in every volunteer was measured weekly for 16 weeks. The body weight measured on the day prior to the first administration of the antibody was used as a baseline weight for each subject. Percentage changes of the body weight relative to the baseline for each subject were calculated and plotted (FIG. 2A). Percentage changes in body weight on day 85 are shown as examples in FIG. 2B. Surprisingly, 30 mg and 100 mg showed the most prominent changes in body weight among all the doses tested, even more so than the highest dose of 200 mg. These results indicate that 30 mg and 100 mg are effective doses of the anti-GFRAL antibody to be used in humans as a therapy.

Example 3: Monotherapy Using an Anti-GFRAL Antibody

Based on the data from Examples 1 and 2, a human trial was designed to test the humanized anti-GFRAL antibody 3P10 (comprising a heavy chain of SEQ ID NO:2010, and a light chain of SEQ ID NO:2012) as a therapy for cancer. 19 human subjects with various cancers were administered subcutaneously once every 3 weeks for the total of 18 weeks (6 cycles) with 30 mg or 100 mg of the antibody. Among the 19 subjects, 7 subjects were diagnosed with colorectal cancer, 4 subjects were diagnosed with pancreatic cancer, and 6 subjects were diagnosed with prostate cancer, 1 patient is diagnosed bladder cancer, and 1 patient is diagnosed with esophageal cancer. The serum GDF15 levels in these subjects ranged from 1290-59600 pg/ml.

1. Safety

During the treatment, dose limiting toxicities, adverse events, serious adverse events, discontinuation of investigational product due to toxicity, and changes from baseline in laboratory parameters, electrocardiograms, vital signs, and local injection-site symptoms were assessed in the subjects. Overall, no dose-limiting toxicities were observed in all the subjects treated with 30 mg or 100 mg of the antibody. Most of the adverse events observed in these subjects were mild or moderate, and were not attributed to the administration of the antibody. Most frequent adverse events included fatigue (observed in 30% of the subjects), insomnia (observed in 25% of the subjects), GGT increase (observed in 20% of the subjects), and nausea (observed in 20% of the subjects). 7 subjects experienced 11 severe adverse events. However, none of them were attributed to the administration of the antibody. Instead, they were attributed to the underlying diseases of the subjects.

2. Pharmacokinetics

During the treatment with the antibody, blood samples were collected from the subjects for measurement of the serum concentrations of the antibody on day 1 (pre-dosing) and day 15 (post-dosing) for the first three cycles and day 1 (pre-dosing) of all the subsequent cycles. The concentrations were determined using an electrochemiluminescence immunoassay on the Meso Scale Diagnostics (MSD) platform. Briefly, a biotinylated monoclonal anti-idiotype antibody of the anti-GFRAL antibody was captured onto a streptavidin coated plate. The plate was then incubated with the serum of the subjects. After thorough washing of the plate to remove the unbound antibodies, a ruthenylated anti-idiotype antibody was added to the plate. Electrochemiluminescence signals were measured after adding the substrate to the plate. The concentration of the anti-GFRAFL antibody in the serum of each subject was calculated based on the standard curve generated using the same platform.

The antibody concentration-time profiles are shown in FIG. 3. From the 10 subjects receiving 30 mg of the antibody, the mean (±standard deviation) trough concentration following the 1^stand 2^nddoses were 1.58 (±0.659) pg/mL and 2.98 (±0.987) pg/mL, respectively. The accumulation ratios based on the trough concentration following the 1^stand 2^nddoses were between 1.26 to 1.73. From the 10 subjects receiving 100 mg of the antibody, the mean (±standard deviation) trough concentration following the 1^stand 2^nddoses were 8.88 (±2.35) μg/mL and 13.2 (±4.43) μg/mL, respectively. The accumulation ratios based on the trough concentration following the 1^stand 2^nddoses were between 1.33 to 1.64.

The serum half-life of the antibody determined from healthy subjects ranges from 28 to 40 days.

3. Reduction of Ketone Body Production

GDF15 induces lipolysis, thereby increasing the production of ketone bodies. Blocking the GDF15-GFRAL-RET signaling pathway decreases lipolysis and as a result reducing ketone body production. The serum level of beta hydroxybutyrate (BHB), a form of ketone bodies, was measured in the subjects on day 14 and day 28 after the antibody administration for the first 4 cycles and then day 28 after the antibody administration for all subsequent cycles. Serum samples were taken from the subjects who had fast for 12 hours, and were sent to a commercial diagnostic lab for measurement of the BHB level.

Both 30 mg and 100 mg of the antibody led to a reduced level of BHB in serum during the 18 week treatment period. In comparison with subjects treated with 30 mg, subjects treated with 100 mg showed a further reduction of BHB in the serum.

4. Lean Body Mass Gain and Tumor Stabilization

Lean body mass (LBM) and tumor response based on CT or MRI scans were performed during the study. A baseline measurement within 28 days before the first administration was obtained and post-treatment measurement every 6 weeks was carried out as long as the patients were on the study. From the 10 patients who obtained at least one scan post-treatment, 4 patients (3 in the 30 mg cohort and 1 in the 100 mg cohort) had increased LBM based on maximum change from baseline.

Tumor progression in the 16 patients was assessed according to the criteria set out from RECIST 1.1. 3 out of the 7 patients in the 30 mg cohort had Stable Disease and 1 out of the 9 patients in the 100 mg cohorts had Partial Response based on their best response.

5. Anti-GFRAL Antibody for Treating Prostate Cancer

Five patients with advanced prostate cancer were treated with 30 or 100 mg of humanized anti-GFRAL antibody 3P10 (comprising a heavy chain of SEQ ID NO:2010, and a light chain of SEQ ID NO:2012) subcutaneously once every 3 weeks. The patients had exhausted all standard therapies and had elevated baseline serum GDF15. All of the patients had previously received three or more lines of therapies. The median age was 65.6 years (range: 53.2 to 81.2 years). Primary endpoints including safety and tolerability, secondary endpoints including pharmacokinetics (PK), tumor progression using RECIST measurement, serum prostate specific antigen (PSA) level, and anti-cachexia effects were assessed in these patients.

Among the patients, their serum GDF15 levels ranged 2070 to 27900 pg/ml; and their serum PSA level ranged from 15 to 1728 ng/ml before the treatment. During the treatment, the anti-GFRAL antibody was well tolerated in all patients with no dose-limiting toxicities. Most of the adverse events observed were grade 1 to 2 and not attributed to the anti-GFRAL antibody treatment. Two out of the five patients had serum PSA reduction, one was −31.7% and the other was over −99% (from 76 ng/ml to <0.1 ng/ml). For the latter patient, the PSA reduction has been durable and sustained for 50 weeks and tumor partial response (PR) has been observed with RECIST assessment. Furthermore, the latter patient significantly elevated serum GDF15 level and high GDF15 expression in the tumor cells. After the treatment, the patient's serum GDF15 level was reduced up to 90% from baseline and body weight increased by up to 9.7%. Analysis of the circulating immune cell composition in the same patient showed an increase of CD8⁺ Tcm (central memory) cells and CD8⁺ T cells with proliferative capacity (Ki67+); and a decrease of immuno-suppressive T-regulatory cells (Treg) and naïve Treg cells. It is noted that this patient had high levels of MicroSatellie Instability (MSI-H), a genotype that-without being bound by any particular theory—may be more likely to respond to therapy of immune modulation.

Example 4: Combination Therapy Using Anti-GFRAL Antibody

Another human trial was designed to test the humanized anti-GFRAL antibody 3P10 (comprising a heavy chain of SEQ ID NO:2010, and a light chain of SEQ ID NO:2012) in combination abraxane (paclitaxel protein-bound particles, also known as “nab-paclitaxel”) and gemcitabine as a therapy for pancreatic cancer.

Eight human subjects diagnosed with metastatic pancreatic adenocarcinoma were administered with the anti-GFRAL antibody in combination with abraxane (nab-paclitaxel) and gemcitabine. The median age was 67 years old. Seven patients were at stage IV disease and previously received FOLFERINOX or gemcitabine-based therapies. The antibody was administered subcutaneously at 30 mg or 100 mg once every 4 weeks. Abraxane was administered at a dose of 125 mg/m²weekly via intravenous infusion over 30-40 minutes for the first 3 weeks during the 4-week cycle (on day 1, day 8, and day 15). Gemcitabine was administered at a dose of 1000 mg/m²via intravenous infusion over 30-40 minutes for the first 3 weeks of the 4-week cycle (on day 1, day 8, and day 15). The serum GDF15 levels in these subjects ranged from 1350-3540 pg/mL.

1. Safety

The anti-GFRAL antibody was well-tolerated. Overall, no dose-limiting toxicities of the antibody were observed in the tested subjects. Most of the observed adverse events and severe adverse events were not attributed to the antibody itself. The most frequent adverse events were diarrhea (observed in 50% of the subjects), nausea (observed in 50% of the subjects), and fatigue (observed in 50% of the subjects), which are commonly seen in the context of gemcitabine/nab-paclitaxel therapy. 5 patients experienced multiple severe adverse events, including sepsis, febrile neutropenia, pancreatitis, diarrhea, vomiting, retroperitoneal hemorrhage, acute kidney injury, cardiac arrest, and encephalopathy. However, none of these events were deemed related to the treatment of antibody itself after medical safety review. Instead, these events were attributed to gemcitabine and abraxane.

2. Pharmacokinetics

During the combination therapy, blood samples were collected from the subjects for measurement of serum concentrations of the antibody on day 1 (pre-dosing), day 8 (post-dosing) and day 15 (post-dosing) during the first four cycles and day 1 (pre-dosing) in all the subsequent cycles. The concentrations were determined in the same manner as described in Example 3, Section 2.

The antibody concentration-time profiles are shown in FIG. 5. From the 4 subjects receiving 30 mg of the antibody in combination with gemcitabine and abraxane, the mean (±standard deviation) trough concentration following the 1^stand 3^rddoses were 1.51 (±1.15) μg/mL and 2.67 (±1.16) μg/mL, respectively. The accumulation ratios based on trough concentration following the 1^stand 3^rddoses were between 1.28 to 3.81. From the 4 subjects receiving 100 mg of the antibody in combination with gemcitabine and abraxane, the mean (±standard deviation) trough concentration following the 1^stand 3^rddoses were 5.40 (±1.62) μg/mL and 10.1 (±4.61) μg/mL, respectively. The accumulation ratios based on trough concentration following the 1^stand 3^rddoses were between 1.17 to 2.32.

3. Tumor Progression

RECIST assessment based on CT or MRI scans were performed during the study to evaluate the patient's tumor progression. A baseline measurement within 28 days before the first administration of the combination therapy was obtained and post-treatment measurement every 8 weeks was carried out as long as the patients were on the study. As shown in FIG. 6, out of the 8 patients who received the combination therapy, 2 patients experienced gemcitabine/nab-paclitaxel related SAEs and discontinued from the study before obtaining their first post-treatment CT scan and, thus, RECIST assessment was not conducted and they were excluded from the analysis. Among the 6 evaluable patients, RECIST assessment showed 3 patients with Partial Response (extending >32 weeks) and 3 patients with Stable Disease. Overall, the disease control rate (DCR) was 100%, medium progression free survival (mPFS) was not reached (2/8 deaths), 12-month survival rate (12-month OS rate) was 83.3%. As a comparison, historic DCR is 50%, mPFS is 5.5 months, 12-month OS rate is 35% and medium overall survival is 8.5 months in metastatic pancreatic cancer (Von Hoff D D, et al. N Engl J Med. 2013, which is incorporated by reference herein in its entirety).

In addition to the CT scan, tumor antigen CA19-9 levels in patients were also assessed. Although not all pancreatic cancers express CA19-9, the antigen is expressed on the surface of many pancreatic cancers and is shed into the circulation. Tests measuring the levels of CA19-9 are therefore used as a less-invasive measurement of tumor burden. CA19-9 is expressed at very low levels in the normal pancreas and the normal CA19-9 range in serum is considered to be <37 U/mL. Blood samples of the patients were collected and CA19-9 levels were measured in a standard assay.

Of the 6 RECIST-evaluable patients, 1 patient was CA19-9 negative (CA19-9 levels <37 U/mL, dotted line in FIG. 7), and 5 patients were CA19-9 positive (CA19-9 levels between 480 and 16,000 U/mL, solid lines in FIG. 7). All 5 CA19-9 positive patients achieved at least a 68% reduction of CA19-9 levels in circulation during the treatment, wherein 4 out of these 5 patients achieved >80% reduction and 3 out of these 5 patients achieved >95% reduction.

4. Lean Body Mass Gain and Body Weight Gain

Cachexia (weight loss of at least 5% during the past 6 months) is common in patients with metastatic pancreatic cancer. Furthermore, up to 30% of follow-up cachexia may be observed within 12 weeks after the start of first-line chemotherapy (Mitsunaga S, et al., Supportive Care in Cancer, 2020). Out of the 8 patients, 6 patients had post-treatment measurements of both lean body mass and body weight.

As shown in FIG. 8, 5 out of 6 patients gained or maintained their LBM based on maximum change from baseline. The average maximal change of lean body mass in the 6 patients was an 4% increase compared to the baseline level.

As shown in FIG. 9, over the course of the study, 5 out of 6 patients gained or maintained their body weight based on maximum change from baseline, achieving a 5-10% increase during the treatment. The average maximal body weight gain across all 6 patients was 6.2%. One patient who initially lost significant weight rebounded to almost the baseline weight during the treatment.

Overall, the data in the Examples show that humanized anti-GFRAL antibody that inhibits GFRAL binding to RET (e.g., humanized 3P10 antibody) can decrease or reverse body weight loss in cancer patients undergoing chemotherapies, suggesting an anti-cachexia effect of anti-GFRAL antibodies.

METHODS OF TREATING CANCER AND TUMOR-RELATED WEIGHT LOSS AND CACHEXIA

Information

Publication Number

Date Filed

Date Published

Inventors

Original Assignees

CPC

International Classifications

Abstract

Description

Claims

I. CROSS-REFERENCE TO RELATED APPLICATION

Provisional Applications (1)