Erythropoietin-stimulating agents and clinical outcomes in metastatic breast cancer patients with chemotherapy-induced anemia: a closed debate?

Erythropoietin-stimulating agents (ESAs) are used in breast cancer patients with chemotherapy-induced anemia to alleviate anemia and in turn, reduce fatigue. These drugs may also decrease overall survival and increase the incidence of serious adverse effects such as thrombovascular events (TVEs). This review evaluates the evidence to date on administering ESAs to breast cancer patients with chemotherapy-induced anemia. Our findings suggest a clear need for well-designed clinical trials that follow current Food and Drug Administration (FDA) ESA label changes to guide clinical practice in an effort to reduce harm to these patients.