17-DMAG blocks a protein-folding helper cells depend on, administered by intravenous infusion in trials only. Longevity interest rests on two rodent findings. The human record is small, with no comparison groups: some durable tumour shrinkage, but also a treatment-related death from kidney failure, heart injury, reversible eye damage, nerve injury and marked fatigue, and a narrow dose window. (Full Review)
| Marker | Target | Why |
|---|---|---|
| ALT and AST | ALT 10–25 U/L (men), 10–20 U/L (women); AST similar | Detects the hepatic injury that was dose-limiting in animals and rose to grade 4 in a patient |
| Total bilirubin | 0.2–0.8 mg/dL | Confirms hepatic excretory function, a trial entry gate |
| Creatinine and eGFR | eGFR above 90 mL/min/1.73 m²; creatinine mid-reference | Renal failure was the single fatal event and appeared within days |
| Serum sodium | 138–142 mmol/L | Grade 3 hyponatraemia occurred at a dose as low as 5 mg/m² |
| Serum albumin | 4.2–5.0 g/dL | Grade 3 hypoalbuminaemia accompanied dose-limiting toxicity and tracks fluid shifts |
| Complete blood count with differential | Neutrophils above 1,500/mm³; platelets above 150,000/mm³; haemoglobin above 13 g/dL (men), 12 g/dL (women) | Marrow toxicity was dose-limiting preclinically and neutropenic fever was common clinically |
| High-sensitivity cardiac troponin | Below the assay's 99th percentile; otherwise track change from the individual's own baseline | Troponin elevation with infarction was a dose-limiting toxicity |
| Left ventricular ejection fraction | 55% or above | Heart failure was a dose-limiting toxicity in the combination trial |
| Corrected QT interval | Below 440 ms | Concurrent QT-prolonging drugs were barred and long QT was an exclusion |
| Ocular surface and visual acuity | No established numeric target; track change from the individual's own baseline in acuity, tear break-up time and corneal staining | Keratitis, dry eye and blurred vision forced dose reductions |
| HSP72 induction in blood mononuclear cells | No established target; track fold-change from the individual's own pre-dose baseline | The only validated marker that the drug reached its target |
| hs-CRP | Below 1.0 mg/L | Tracks the inflammatory burden that senolytic therapy is hypothesised to reduce |
Cadence: Chemistry, blood count and electrocardiogram before every dose and again at 48 hours; ejection fraction every 8–12 weeks; ophthalmological examination every 4 weeks while dosing continues, then at 3 and 6 months after the last dose.