Clinical and Translational Oncology

, Volume 12, Issue 12, pp 843–848 | Cite as

Efficacy of epoetin-beta 30,000 IU/week in correcting anaemia in patients with gastrointestinal tumours subjected to concomitant chemoradiotherapy

  • Antonio Gómez
  • Mercedes Salgado
  • Manuel Valladares-Ayerbes
  • Mónica Jorge
  • Ana Carballo
  • Sonia Candamio
  • Pilar Izquierdo
  • Paula Peleteiro
  • Rafael López
Research Articles

Abstract

Objective

The aim of the project was to assess the effectiveness and safety of weekly epoetin-beta (EB) in patients with gastrointestinal cancer (GIC) subjected to concomitant chemoradiotherapy (CCTRT).

Methods

In this clinical prospective and multicentre cohort study EB was administered at a dose of 30,000 IU/ week, during CCTRT and in the four weeks thereafter, and suspended if haemoglobin (Hb) increased >2 g/dl or Hb >12–13 g/dl. Effectiveness was defined as Hb increase ≥1 g/dl vs. baseline. Time to response, treatment toxicity and transfusion requirements were also assessed.

Results

EB was effective in 75.8% of the evaluable population within a median of four weeks from EB initiation, without blood transfusions. Over 80% of all patients remained below the threshold (Hb ≤13 g/dl) and no study drug-related adverse reactions were recorded.

Conclusion

Weekly EB proved to be effective and well tolerated by patients with GIC subjected to CCTRT.

Keywords

Gastrointestinal cancer Epoetin-beta Anaemia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Blohmer JU, Dunst J, Harrison L et al (2005) Cancer-related anaemia: biological findings, clinical implications and impact on quality of life The European Cancer Anaemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Oncology 68[Suppl 1]:12–21PubMedCrossRefGoogle Scholar
  2. 2.
    Littlewood TJ, Cella D, Nortier JW (2002) Erythropoietin improves quality of life. Lancet Oncol 3: 459–460PubMedCrossRefGoogle Scholar
  3. 3.
    Suzuki Y, Tokuda Y, Fujiwara Y et al (2008) Weekly epoetin beta maintains haemoglobin levels and improves quality of life in patients with non-myeloid malignancies receiving chemotherapy. Jpn J Clin Oncol 38:214–221PubMedCrossRefGoogle Scholar
  4. 4.
    Dubsky P, Sevelda P, Jakesz R et al (2008) Anemia is a significant prognostic factor in local relapse-free survival of premenopausal primary breast cancer patients receiving adjuvant cyclophosphamide/ methotrexate/5-fluorouracil chemotherapy. Clin Cancer Res 14:2082–2087PubMedCrossRefGoogle Scholar
  5. 5.
    Caro JJ, Salas M, Ward A, Goss G (2001) Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 91:2214–2221PubMedCrossRefGoogle Scholar
  6. 6.
    Knight K, Wade S, Balducci L (2004) Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med 116[Suppl 7A]:11S–26SPubMedCrossRefGoogle Scholar
  7. 7.
    Morstyn G, Burgess AW (1988) Hemopoietic growth factors: a review. Cancer Res 48:5624–5637PubMedGoogle Scholar
  8. 8.
    Chapman CE, Stainsby D, Jones H et al (2009) Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma. Transfusion 49:440–452PubMedCrossRefGoogle Scholar
  9. 9.
    Glaspy JA (2009) Erythropoietin in cancer patients. Annu Rev Med 60:181–192PubMedCrossRefGoogle Scholar
  10. 10.
    Fonseca P, Esteban E, de Vicente P et al (2008) Impact of erythropoietin on the reduction of blood transfusions and on survival of lung cancer patients receiving first-line chemotherapy. Clin Transl Oncol 10:426–432PubMedCrossRefGoogle Scholar
  11. 11.
    Groopman JE, Itri LM (1999) Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 91:1616–1634PubMedCrossRefGoogle Scholar
  12. 12.
    Aapro M, Leonard RC, Barnadas A et al (2008) Effect of once-weekly epoetin beta on survival in patients with metastatic breast cancer receiving anthracycline- and/or taxane-based chemotherapy: results of the Breast Cancer-Anemia and the Value of Erythropoietin (BRAVE) study. J Clin Oncol 26:592–598PubMedCrossRefGoogle Scholar
  13. 13.
    Glimelius B, Linne T, Hoffman K et al (1998) Epoetin beta in the treatment of anemia in patients with advanced gastrointestinal cancer. J Clin Oncol 16:434–440PubMedGoogle Scholar
  14. 14.
    Morishima Y, Ogura M, Yoneda S et al (2006) Once-weekly epoetin-beta improves hemoglobin levels in cancer patients with chemotherapy-induced anemia: a randomized, double-blind, dose-finding study. Jpn J Clin Oncol 36:655–661PubMedCrossRefGoogle Scholar
  15. 15.
    Ray-Coquard I, Tourani J, Facon T et al (2007) Epoetin beta treatment of chemotherapy induced anemia in cancer patients: results of a large prospective cohort study. J Clin Oncol (Meeting Abstracts) 25:19582Google Scholar
  16. 16.
    Salgado M, Gómez A, Valladares M et al (2008) Efficacy of epoetin-beta 30,000 iu/week in correcting anemia in patients with gastrointestinal tumors subjected to concomitant chemo-radiotherapy. ASCO. Gastrointestinal Cancers Symposium. Category: Colon and Rectum — Multidisciplinary Treatment, Abstract No. 517Google Scholar
  17. 17.
    Strauss HG, Haensgen G, Dunst J et al (2008) Effects of anemia correction with epoetin beta in patients receiving radiochemotherapy for advanced cervical cancer. Int J Gynecol Cancer 18:515–524PubMedCrossRefGoogle Scholar
  18. 18.
    Heras P, Kritikos K, Hatzopoulos A, Mitsibounas D (2008) Once-weekly epoetin beta therapy in patients with solid tumours and chemotherapy-induced anaemia: a randomized, double-blind, dose-finding study. Eur J Cancer Care (Engl) 17:619–623Google Scholar
  19. 19.
    Bokemeyer C, Aapro MS, Courdi A et al (2007) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 43:258–270PubMedCrossRefGoogle Scholar
  20. 20.
    Aapro M, Van Erps J, MacDonald K et al (2009) Managing cancer-related anaemia in congruence with the EORTC guidelines is an independent predictor of haemoglobin outcome: Initial evidence from the RESPOND study. Eur J Cancer 45:8–11PubMedCrossRefGoogle Scholar
  21. 21.
    Aapro MS, Birgegard G, Bokemeyer C et al (2008) Erythropoietins should be used according to guidelines. Lancet Oncol 9:412–413PubMedCrossRefGoogle Scholar
  22. 22.
    Demetri GD (2006) Evidence-based use of hematopoietic growth factors for optimal supportive care of patients with cancer. Oncology 1535–1544Google Scholar
  23. 23.
    Barrett-Lee PJ, Ludwig H, Birgegard G et al (2006) Independent risk factors for anemia in cancer patients receiving chemotherapy: results from the European Cancer Anaemia Survey. Oncology 70:34–48PubMedCrossRefGoogle Scholar
  24. 24.
    Dalton J, Bailey N, Barrett-Lee P, O’Brien M (1998) Multicenter UK audit of anemia in patients receiving cytotoxic chemotherapy. Proc Am Soc Clin Oncol 17:418a (Abstract 1611)Google Scholar
  25. 25.
    Ludwig H, Van Belle S, Barrett-Lee P et al (2004) The European Cancer Anaemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer 40:2293–2306PubMedCrossRefGoogle Scholar
  26. 26.
    Imbesi JJ, Kurtz RC (2005) A multidisciplinary approach to gastrointestinal bleeding in cancer patients. J Support Oncol 3:101–110PubMedGoogle Scholar
  27. 27.
    Ross SD, Elaine Allen I, Henry DH et al (2006) Clinical benefits and risks associated with epoetin and darbepoetin in patients with chemotherapy-induced anemia: a systematic review of the literature. Clin Ther 28:801–831PubMedCrossRefGoogle Scholar
  28. 28.
    Park SH, Nam E, Bang SM et al (2008) A randomized trial of anemia correction with two different hemoglobin targets in the first-line chemotherapy of advanced gastric cancer. Cancer Chemother Pharmacol 62:1–9PubMedCrossRefGoogle Scholar
  29. 29.
    Moehler MH, Geissler M, Raedle J et al (2007) Erythropoetin (epoetin beta) once weekly in anemic patients with advanced cancer of the stomach or gastroesophageal junction: interim results of a randomized German AIO phase II trail. J Clin Oncol (Meeting Abstracts) 25:15133Google Scholar
  30. 30.
    Rizzo JD, Somerfield MR, Hagerty KL et al (2008) Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update. J Clin Oncol 26: 132–149PubMedCrossRefGoogle Scholar
  31. 31.
    Park SH, Lee J, Lee SH et al (2006) Anemia is the strongest prognostic factor for outcomes of 5-fluorouracil- based first-line chemotherapy in patients with advanced gastric cancer. Cancer Chemother Pharmacol 57:91–96PubMedCrossRefGoogle Scholar
  32. 32.
    Cullinan SA, Moertel CG, Wieand HS et al (1994) Controlled evaluation of three drug combination regimens versus fluorouracil alone for the therapy of advanced gastric cancer. North Central Cancer Treatment Group. J Clin Oncol 12:412–416PubMedGoogle Scholar
  33. 33.
    Henke M, Laszig R, Rube C et al (2003) Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial. Lancet 362:1255–1260PubMedCrossRefGoogle Scholar
  34. 34.
    Ludwig H, Aapro M, Bokemeyer C et al (2009) Treatment patterns and outcomes in the management of anaemia in cancer patients in Europe: Findings from the Anaemia Cancer Treatment (ACT) study. Eur J Cancer 45:1603–1615PubMedCrossRefGoogle Scholar

Copyright information

© Feseo 2010

Authors and Affiliations

  • Antonio Gómez
    • 1
  • Mercedes Salgado
    • 2
  • Manuel Valladares-Ayerbes
    • 3
  • Mónica Jorge
    • 4
  • Ana Carballo
    • 1
  • Sonia Candamio
    • 5
  • Pilar Izquierdo
    • 5
  • Paula Peleteiro
    • 1
  • Rafael López
    • 6
  1. 1.Servicio de Oncología RadioterápicaHospital Clínico Universitario Santiago de CompostelaSantiago de Compostela, La CoruñaSpain
  2. 2.Servicio de Oncología MédicaComplejo Hospitalario de OrenseOrenseSpain
  3. 3.Servicio de Oncología MédicaComplejo Hospitalario Universitario de La CoruñaLa CoruñaSpain
  4. 4.Servicio de Oncología MédicaComplejo Hospitalario de VigoVigo, PontevedraSpain
  5. 5.Servicio de Oncología MédicaComplejo Hospitalario UniversitarioSantiago de Compostela, La CoruñaSpain
  6. 6.Servicio de Oncología RadioterápicaCentro Oncológico de La CoruñaLa CoruñaSpain

Personalised recommendations