Source: DGNews  |  Posted 8 years ago

By Charlene Laino

NEW YORK, NY -- November 21, 2003 -- Treatment with recombinant erythropoetin or darbepoetin significantly improves anaemia and quality of life in patients with advanced non-small-cell lung cancer (NSCLC), attendees were told here on November 14th at the Chemotherapy Foundation Symposium XXI.

"In the treatment of patients with advanced NSCLC, anaemia is clinically relevant," said Corey Langer, MD, Director of Thoracic and Head & Neck Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, United States.

That conclusion is supported by several trials, including a randomised Phase III study of proactive versus reactive recombinant erythropoetin in non-anaemic patients with advanced NSCLC receiving 8 or more weeks of cytotoxic therapy (Proc Am Soc Clin Oncol 22: page 628, 2003 [abstract 2527]).

In the trial, 216 patients with Stage IIIB/IV NSCLC were randomised to receive 40,000 U of recombinant epoetin alfa subcutaneously once weekly or reactive use of the drug once haemoglobin dropped below 10 g/dL. Epoetin alfa was increased by 20,000 U a week if haemoglobin decreased more than 2 g/dL from baseline after 4 weeks, and was decreased by 20,000 U weekly if haemoglobin rose above 15 g/dL.

The study showed that haemoglobin dropped to below 10 g/dL in 18% of patients in the proactive group, compared with 44% of control subjects (P = .0001). Nearly 50% of patients in the reactive group required a switch to epoetin alfa, Dr. Langer added. Epoetin alfa was well tolerated, with no differences between the groups in the frequency or patterns of side effects.

In another Phase III trial that pitted darbepoetin alfa against placebo in anaemic lung-cancer patients, only 28% of those in the intervention group required a transfusion, compared with 57% of those in the placebo arm (P < .001), Dr. Langer said. (Eur J Cancer 2001,3,264, Abstract 981).

Also, 66% of those in the treated group experienced a rise in haemoglobin to above 12 g/dL, or at least a 2-g increase from baseline, compared with 24% in the placebo group, the study showed. Again this was significant at the P < .001 level, Dr. Langer said.

The results of these trials and others shows that "intervention with recombinant erythropoetin or darbepoetin is clinically relevant for patients with NSCLC, significantly improving anaemia and quality of life, and reducing transfusion requirements," Dr. Langer concluded.

[Study Title: The Impact of Anemia in Lung Cancer: Prognostic and therapeutic Implications. Abstract 57]