Epoetin-β treatment in patients with cancer chemotherapy-induced anaemia: the impact of initial haemoglobin and target haemoglobin levels on survival, tumour progression and thromboembolic events

Autor:	Hans-Ulrich Burger, Osterwalder B, Armin Scherhag, Matti S. Aapro
Rok vydání:	2009
Předmět:	Oncology anaemia Cancer Research Epoetin beta medicine.medical_specialty Anemia business.industry Colorectal cancer Cancer epoetin-β medicine.disease survival Surgery Prostate cancer Breast cancer Erythropoietin Tumor progression Internal medicine Clinical Studies medicine business medicine.drug
Zdroj:	British Journal of Cancer
ISSN:	1532-1827 0007-0920
DOI:	10.1038/sj.bjc.6605255
Popis:	Background: Epoetin-β is used to treat patients with cancer undergoing chemotherapy to alleviate the symptoms of anaemia, reduce the risk of blood transfusions and improve quality of life (QoL). Methods: This meta-analysis of all 12 randomised, controlled studies of epoetin-β evaluated the impact of therapy at different Hb-initiation levels and to different target Hb levels on overall survival, tumour progression and thromboembolic events (TEE). An analysis of risk factors pre-disposing patients to TEEs under epoetin-β therapy was also performed. A total of 2297 patients are included in the analysis. Results: Analyses based on various Hb-initiation levels indicate no detrimental impact on survival (HR 0.99; 95% CI 0.70, 1.40) and a favourable impact on disease progression (HR 0.73; 95% CI 0.57, 0.94) when epoetin-β was used within its licensed indication (Hb initiation ⩽10 g dl−1) or the EORTC recommended level of 11 g dl−1. An increased risk of TEEs is seen for all Hb-initiation level strata and a detrimental impact on survival is seen when initiating epoetin-β therapy at Hb levels >11 g dl−1. We observe no association between high target Hb levels (⩾13 g dl−1) and an increased risk of mortality, disease progression or TEEs with epoetin-β compared with control. Conclusion: The results of this analysis indicate that epoetin-β therapy has no detrimental impact on survival or tumour progression when initiated at Hb levels up to 11 g dl−1. Furthermore, there is no evidence to suggest that high Hb values achieved during epoetin-β therapy are associated with an increased mortality, disease progression or TEE rate.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c2dbeda59a88a41a461b241859f12c9f https://doi.org/10.1038/sj.bjc.6605255 Zobrazit plný text záznamu Plný text ve formátu PDF