NEW YORKWeekly injections of epoetin alfa (Procrit) might protect
breast cancer patients against anemia and improve their quality of life
during adjuvant chemotherapy.
Interim results from the first 852 women in a large multicenter study
show significant gains in energy and activity as well as in hemoglobin
levels compared to historic data on women who did not receive erythropoietic
therapy during adjuvant chemotherapy (ASCO abstract 1518). Up to 1,700 women
with mid-range hemoglobin levels are to be enrolled in the ongoing phase IV
study, and a randomized trial is contemplated, according to lead
investigator Clifford A. Hudis, MD, chief of the Breast Cancer Medicine
Service at Memorial Sloan-Kettering Cancer Center in New York City.
"The bottom line, we think, is that this suggests the possibility
that weekly epoetin alfa will maintain hemoglobin in adjuvant therapy
patients," Dr. Hudis told ONI. ‘‘It will protect against anemia. We
are being very conservative; it will moderate decreases in quality of life.
In fact it looks like [the patients] get a little bit better. And we need a
prospective randomized trial to ever be definitive about these things."
Expansion in Thinking
The investigation represents an expansion in thinking about what
erythropoietic therapy can do for patients, according to Dr. Hudis. In the
early 1990s, research focused on improving hemoglobin levels in anemic
patients and on avoiding transfusions, but it was directed mostly at
patients near the end of life, he said.
Later studies began to look at the impact on quality of life, but still
in the sickest patients. Only recently have investigations begun to look at
whether erythropoietic therapy can have a positive impact on healthier
patients and perhaps protect cognitive functioning during chemotherapy.
"These are potent biological agents, and they may have an effect
beyond simply inducing red cell count," Dr. Hudis said.