Review Article

Supportive Care in Cancer

, Volume 21, Issue 8, pp 2359-2369

First online:

Prognostic impact of the combination of erythropoiesis-stimulating agents to cancer treatment: literature review

  • L. BoulaamaneAffiliated withDepartment of Medical Oncology, National Institute of Oncology Email author 
  • , A. GoncalvesAffiliated withDepartment of Medical Oncology, Paoli-Calmettes Institute
  • , S. BoutayebAffiliated withDepartment of Medical Oncology, National Institute of Oncology
  • , P. ViensAffiliated withDepartment of Medical Oncology, Paoli-Calmettes Institute
  • , H. M’rabtiAffiliated withDepartment of Medical Oncology, National Institute of Oncology
  • , F. BertucciAffiliated withDepartment of Medical Oncology, Paoli-Calmettes Institute
  • , H. ErrihaniAffiliated withDepartment of Medical Oncology, National Institute of Oncology

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Abstract

Cancer patients commonly develop anaemia. Erythropoiesis-stimulating agents (ESAs) are frequently used in cancer treatment. Numerous controlled studies indicate that ESAs can raise haemoglobin levels, reduce transfusion requirements and improve quality of life in anaemic cancer patients receiving chemotherapy. They were previously used to enhance response to radiation therapy, via increasing tumour cell oxygenation. Since the 2002 guideline, there has been increasing attention to the safety of ESA treatment in patients with cancer. Two placebo-controlled phase III randomised clinical trials published in 2003 showed evidence of harmful effects of ESAs on survival and/or tumour outcomes. Subsequently, recent trials and several large meta-analyses have confirmed negative impact on survival and/or disease progression. To comprehensively examine whether ESA use affects safety outcomes in cancer patients in different settings (chemotherapy, radiotherapy and targeted therapies), we conducted a literature review of all clinical trials, small and large meta-analyses from 1990 to 2012.

Keywords

Epoetin Darbepoetin Erythropoiesis-stimulating agents Survival Progression-free survival Meta-analysis