G D Demetri1, M Kris, J Wade, L Degos, D Cella. 1. Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02115, USA. george_demetri@dfci.harvard.edu
Abstract
PURPOSE: To evaluate prospectively the effectiveness of epoetin alfa as an adjunct to chemotherapy in patients with cancer based on changes in quality-of-life parameters and hemoglobin levels, and to correlate these changes with antitumor response. PATIENTS AND METHODS: Two thousand three hundred seventy patients with nonmyeloid malignancies who received chemotherapy were enrolled onto this study from 621 US community-based practices. Patients received epoetin alfa 10,000 U three times weekly, which could be increased to 20,000 U three times weekly depending on the hemoglobin response at 4 weeks. Treatment continued for a maximum of 16 weeks in patients who showed evidence of hematologic response. RESULTS: Two thousand two hundred eighty-nine patients (97%) were eligible for efficacy analyses. Epoetin alfa therapy was associated with improved quality-of-life parameters; these improvements correlated significantly with hemoglobin levels and were independent of tumor response. Provider-reported Karnofsky performance scores did not correlate with the improved quality-of-life changes. Epoetin alfa therapy was also associated with a significant increase in hemoglobin levels and decrease in transfusion use. Tumor type, chemotherapy agent/regimen, prior chemotherapy, baseline hemoglobin level, and baseline erythropoietin level were not predictive of a positive response to treatment. Epoetin alfa was well tolerated. CONCLUSION: Epoetin alfa appears to have a beneficial impact on patient-reported functional capacity and quality of life in patients with cancer who received chemotherapy independent of tumor response. Concordantly, epoetin alfa appeared to increase hemoglobin levels and decrease transfusion use. Patients responded across all tumor types. The results suggest that epoetin alfa effectively improves functional outcomes in patients with cancer who receive chemotherapy.
PURPOSE: To evaluate prospectively the effectiveness of epoetin alfa as an adjunct to chemotherapy in patients with cancer based on changes in quality-of-life parameters and hemoglobin levels, and to correlate these changes with antitumor response. PATIENTS AND METHODS: Two thousand three hundred seventy patients with nonmyeloid malignancies who received chemotherapy were enrolled onto this study from 621 US community-based practices. Patients received epoetin alfa 10,000 U three times weekly, which could be increased to 20,000 U three times weekly depending on the hemoglobin response at 4 weeks. Treatment continued for a maximum of 16 weeks in patients who showed evidence of hematologic response. RESULTS: Two thousand two hundred eighty-nine patients (97%) were eligible for efficacy analyses. Epoetin alfa therapy was associated with improved quality-of-life parameters; these improvements correlated significantly with hemoglobin levels and were independent of tumor response. Provider-reported Karnofsky performance scores did not correlate with the improved quality-of-life changes. Epoetin alfa therapy was also associated with a significant increase in hemoglobin levels and decrease in transfusion use. Tumor type, chemotherapy agent/regimen, prior chemotherapy, baseline hemoglobin level, and baseline erythropoietin level were not predictive of a positive response to treatment. Epoetin alfa was well tolerated. CONCLUSION:Epoetin alfa appears to have a beneficial impact on patient-reported functional capacity and quality of life in patients with cancer who received chemotherapy independent of tumor response. Concordantly, epoetin alfa appeared to increase hemoglobin levels and decrease transfusion use. Patients responded across all tumor types. The results suggest that epoetin alfa effectively improves functional outcomes in patients with cancer who receive chemotherapy.
Authors: Arti Hurria; Ilene S Browner; Harvey Jay Cohen; Crystal S Denlinger; Mollie deShazo; Martine Extermann; Apar Kishor P Ganti; Jimmie C Holland; Holly M Holmes; Mohana B Karlekar; Nancy L Keating; June McKoy; Bruno C Medeiros; Ewa Mrozek; Tracey O'Connor; Stephen H Petersdorf; Hope S Rugo; Rebecca A Silliman; William P Tew; Louise C Walter; Alva B Weir; Tanya Wildes Journal: J Natl Compr Canc Netw Date: 2012-02 Impact factor: 11.908
Authors: Matti S Aapro; David C Dale; Michael Blasi; Brenda Sarokhan; Fawzia Ahmed; Richard C Woodman Journal: Support Care Cancer Date: 2006-06-07 Impact factor: 3.603
Authors: Fabian Finkelmeier; Dominik Bettinger; Verena Köberle; Michael Schultheiß; Stefan Zeuzem; Bernd Kronenberger; Albrecht Piiper; Oliver Waidmann Journal: Med Oncol Date: 2013-12-11 Impact factor: 3.064
Authors: Silas C Martin; Dennis D Gagnon; Lucy Zhang; Carsten Bokemeyer; Marinus Van Marwijk Kooy; Ben van Hout Journal: Pharmacoeconomics Date: 2003 Impact factor: 4.981
Authors: Bing Zhou; Jeffrey S Damrauer; Sean T Bailey; Tanja Hadzic; Youngtae Jeong; Kelly Clark; Cheng Fan; Laura Murphy; Cleo Y Lee; Melissa A Troester; C Ryan Miller; Jian Jin; David Darr; Charles M Perou; Ross L Levine; Maximilian Diehn; William Y Kim Journal: J Clin Invest Date: 2014-01-02 Impact factor: 14.808
Authors: Thomas Thomaidis; Arndt Weinmann; Martin Sprinzl; Stephan Kanzler; Jochen Raedle; Matthias Ebert; Carl Cristoph Schimanski; Peter Robert Galle; Thomas Hoehler; Markus Moehler Journal: Int J Clin Oncol Date: 2013-03-27 Impact factor: 3.402