Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes
2010/01/01 by John A. Glaspy, J Glaspy, Jeffrey Crawford +17 · 26 citations
Medicine · #Erythropoietin and Anemia Treatment #Blood transfusion and management #Inflammatory Biomarkers in Disease Prognosis
paper · pdf · doi:10.1038/sj.bjc.6605498
Abstract
BACKGROUND: Cancer patients often develop the potentially debilitating condition of anaemia. Numerous controlled studies indicate that erythropoiesis-stimulating agents (ESAs) can raise haemoglobin levels and reduce transfusion requirements in anaemic cancer patients receiving chemotherapy. To evaluate recent safety concerns regarding ESAs, we carried out a meta-analysis of controlled ESA oncology trials to examine whether ESA use affects survival, disease progression and risk of venous-thromboembolic events. METHODS: This meta-analysis included studies from the 2006 Cochrane meta-analysis, studies published/updated since the 2006 Cochrane report, and unpublished trial data from Amgen and Centocor Ortho Biotech. The 60 studies analysed (15 323 patients) were conducted in the settings of chemotherapy/radiochemotherapy, radiotherapy only treatment or anaemia of cancer. Data were summarised using odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: Results indicated that ESA use did not significantly affect mortality (60 studies: OR=1.06; 95% CI: 0.97-1.15) or disease progression (26 studies: OR=1.01; 95% CI: 0.90-1.14), but increased the risk for venous-thromoboembolic events (44 studies: OR=1.48; 95% CI: 1.28-1.72). CONCLUSION: Though this meta-analysis showed no significant effect of ESAs on survival or disease progression, prospectively designed, future randomised clinical trials will further examine the safety and efficacy of ESAs when used according to the revised labelling information.
Cited by
- Effects of erythropoiesis-stimulating agents on fatigue- and anaemia-related symptoms in cancer patients: systematic review and meta-analyses of published and unpublished data
- Epoetin alpha decreases the number of erythrocyte transfusions in patients with acute lymphoblastic leukemia, lymphoblastic lymphoma, and Burkitt leukemia/lymphoma: results of a randomized clinical trial. [europepmc]
- Hemoglobin level at initiation of darbepoetin alfa: impact on need for transfusion and associated costs in chemotherapy-induced anemia treatment in Europe. [europepmc]
- The effect of erythropoietin on normal and neoplastic cells. [europepmc]
- A review of safety, efficacy, and utilization of erythropoietin, darbepoetin, and peginesatide for patients with cancer or chronic kidney disease: a report from the Southern Network on Adverse Reactions (SONAR). [europepmc]
- Erythropoietin or darbepoetin for patients with cancer. [europepmc]
- Prevalence and management of anaemia in patients with non-myeloid cancer undergoing systemic therapy: a Spanish survey. [europepmc]
- Meta-analysis of epoetin beta and darbepoetin alfa treatment for chemotherapy-induced anemia and mortality: Individual patient data from Japanese randomized, placebo-controlled trials. [europepmc]
- Anaemia of chronic disease. [europepmc]
- Post-diagnosis hemoglobin change associates with overall survival of multiple malignancies - results from a 14-year hospital-based cohort of lung, breast, colorectal, and liver cancers. [europepmc]
- Erythropoietin is a JAK2 and ERK1/2 effector that can promote renal tumor cell proliferation under hypoxic conditions. [europepmc]
- Functional EpoR pathway utilization is not detected in primary tumor cells isolated from human breast, non-small cell lung, colorectal, and ovarian tumor tissues. [europepmc]
- Pharmacological treatments for fatigue associated with palliative care. [europepmc]
- Targeting EPO and EPO receptor pathways in anemia and dysregulated erythropoiesis. [europepmc]
- The role of iron in the management of chemotherapy-induced anemia in cancer patients receiving erythropoiesis-stimulating agents. [europepmc]
- Erythropoietin increases macrophage-mediated T cell suppression. [europepmc]
- Anemia and Iron Deficiency in Cancer Patients: Role of Iron Replacement Therapy. [europepmc]
- Anemia is associated with poor outcomes of metastatic castration-resistant prostate cancer, a systematic review and meta-analysis. [europepmc]
- Ferric Carboxymaltose in the treatment of chemotherapy-induced anaemia: an effective, safe and cost- sparing alternative to blood transfusion. [europepmc]
- Pharmacological cancer treatment and venous thromboembolism risk. [europepmc]
- Considerations for Use of Hematopoietic Growth Factors in Patients With Cancer Related to the COVID-19 Pandemic. [europepmc]
- Role of the erythropoietin receptor in Lung Cancer cells: erythropoietin exhibits angiogenic potential. [europepmc]
- SEOM clinical guidelines for anaemia treatment in cancer patients (2020). [europepmc]
- Experimental Drugs for Chemotherapy- and Cancer-Related Anemia. [europepmc]
- Intravenous Iron Therapy to Treat Anemia in Oncology: A Mapping Review of Randomized Controlled Trials. [europepmc]
- The effect of erythropoiesis‑stimulating agents on lung cancer patients: a meta‑analysis. [europepmc]
Related