Abstract | OBJECTIVE:
Darbepoetin alfa is effective in treating chemotherapy-induced anemia (CIA). Administration of subcutaneous darbepoetin alfa every 3 weeks (Q3W) could simplify treatment through synchronization with common Q3W chemotherapy regimens. We report results from a multicenter, randomized, double-blind, placebo-controlled, phase 3 trial evaluating the efficacy and safety of fixed-dose Q3W darbepoetin alfa in patients with a wide variety of tumor types who experienced CIA. RESEARCH DESIGN AND METHODS: Patients aged > or = 18 years with anemia ( hemoglobin <11 g/dL) being treated for nonmyeloid malignancy were randomized 1:1 to receive darbepoetin alfa 300 microg (n = 193) or placebo (n = 193) subcutaneously Q3W from weeks 1 to 13 in this 16-week study. Doses could be adjusted per prespecified rules. MAIN OUTCOME MEASURES: The primary endpoint was the proportion of patients who received > or =1 red blood cell (RBC) transfusion between week 5 and the end of the treatment period (EOTP). The study also analyzed the proportions of patients achieving a hemoglobin concentration > or =11 g/dL and subsequently maintaining hemoglobin levels above 11 g/dL, and the change in hemoglobin concentration over time. RESULTS: The proportion of patients requiring RBC transfusions between week 5 and EOTP was significantly lower in the darbepoetin alfa-treated group than in the placebo-treated group (24 vs. 41% of patients, a 16.3% difference, p < 0.001). There were no differences between the two treatment arms in quality-of-life measures. Cardiovascular/thromboembolic adverse events were uncommon and were not associated with increases in hemoglobin levels. Study limitations suggest caution in the interpretation of these results: transfusions, the primary endpoint, were recommended but not required if hemoglobin concentrations were < or =8.0 g/dL, and protocol deviations (primarily dosing errors) occurred in approximately one-half of the patients in both treatment groups. CONCLUSIONS: In this study, fixed-dose Q3W darbepoetin alfa appeared to be well-tolerated and effective for the treatment of CIA. TRIAL REGISTRATION: Study 20030232; ClinicalTrials.Gov Identifier: NCT00110955.
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Authors | Enrique Hernandez, Peter Ganly, Veena Charu, Joseph Dibenedetto, Dianne Tomita, Tom Lillie, Kerry Taylor, ARANESP 20030232 Study Group |
Journal | Current medical research and opinion
(Curr Med Res Opin)
Vol. 25
Issue 9
Pg. 2109-20
(Sep 2009)
ISSN: 1473-4877 [Electronic] England |
PMID | 19601709
(Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Placebos
- Erythropoietin
- Darbepoetin alfa
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Algorithms
- Anemia
(drug therapy, etiology)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Darbepoetin alfa
- Dose-Response Relationship, Drug
- Double-Blind Method
- Drug Administration Schedule
- Erythropoietin
(administration & dosage, analogs & derivatives)
- Female
- Humans
- Male
- Middle Aged
- Neoplasms
(drug therapy)
- Placebos
- Young Adult
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