Epoetin beta in the treatment of anemia in patients with advanced gastrointestinal cancer.

Abstract

PURPOSE:

The possibility that epoetin beta (EPO) could increase hemoglobin (B-Hb) levels and improve quality of life (QoL) in patients with advanced gastrointestinal cancers was investigated.

PATIENTS AND METHODS:

One hundred patients with gastric, pancreatic, biliary, or colorectal cancers and subnormal B-Hb levels were included in a randomized study to test low-dose EPO (2,000 U subcutaneously thrice weekly [2,000 group]) against a higher dose (10,000 U times three [10,000 group]). Eighty-four patients were treated with chemotherapy. QoL was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 instrument.

RESULTS:

At baseline, mean B-Hb was 108 g/L with no difference between the groups. In the 10,000 group, an increase in B-Hb (>10 g/L) was seen in 30 (73%) patients treated with chemotherapy, after a median of 4 weeks, whereas a corresponding increase in the 2,000 group was seen in 15 (30%) patients after a median of 10 weeks (P < .001). A difference in the proportion of responders (five of eight v one of eight) was also seen in the group of patients not treated with chemotherapy. The proportion of responders was independent of baseline endogenous serum EPO level or observed/predicted log10 serum (S)-EPO levels. Patients who demonstrated improved B-Hb levels also showed improvements in QoL parameters. Tumor response was usually also associated with QoL improvements.

CONCLUSION:

Treatment with EPO at a dose of 10,000 U thrice weekly can rapidly and safely increase B-Hb levels in a high proportion of patients with advanced gastrointestinal cancers. QoL is influenced by the B-Hb increase, but also by the course of the underlying malignancy. It is therefore difficult to define clearly the clinical relevance of the B-Hb increase as such.

• Authors: B Glimelius, T Linné, K Hoffman, L Larsson, J H Svensson, P Näsman, B Svensson, C Helmers
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 16 Issue 2 Pg. 434-40 (Feb 1998) ISSN: 0732-183X [Print] United States
• PMID: 9469326 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Hemoglobins
• Recombinant Proteins
• epoetin beta
• Erythropoietin

Topics

• Adult
• Aged
• Anemia (blood, etiology, therapy)
• Erythropoietin (therapeutic use)
• Female
• Gastrointestinal Neoplasms (complications, drug therapy)
• Hemoglobins (analysis)
• Humans
• Male
• Middle Aged
• Quality of Life
• Recombinant Proteins