SAN FRANCISCOWeekly doses of recombinant human
erythropoietin (epoetin alfa [Procrit, Eprex, Erypo]) improved quality of life
as well as hemoglobin levels for 154 lung cancer patients in a 16-week,
nonrandomized pilot study. Self-assessments from patients at baseline, 8, and
16 weeks showed that their energy rose by 30% above baseline, activity by
30.6%, and overall quality of life by 22%.
As a result of the outcomes, investigators are recruiting 300
patients for a multicenter randomized trial, according to Chandra P. Belani,
MD, professor of medicine at the University of Pittsburgh School of Medicine.
The study demonstrated that weekly doses of epoetin alfa were safe and
confirmed the results of other studies that have shown quality of life benefits
in addition to increase in hemoglobin levels when epoetin is used in patients
receiving chemotherapy, Dr. Belani reported.
"While patients are getting chemotherapy, most patients
have anemia. We need to be proactive in treating it. We need to maintain
hemoglobin levels at or above 11 to 13 g/dL to get maximum quality of life and
not wait until it goes down and they complain of fatigue," Dr. Belani
Also Received Chemotherapy and Radiation Therapy
Investigators at the Beth Israel Medical Center/St. Luke’s-Roosevelt
Hospital in New York City and Ortho Biotech Products, LP, in Raritan, New
Jersey, also participated in the pilot study. "This trial fairly clearly
and significantly demonstrates a quality-of-life benefit from once weekly
epoetin alfa," commented Daniel P. Shasha, MD, of Beth Israel Medical
Center in New York City, noting that the benefit correlated with the degree of
correction of anemia. "All patients benefited, and the benefit was the
most in the patients who were the most anemic." The investigators did not
look at the long-term effects of epoetin alfa on local control and survival,
but plan to do so in the randomized trial, Dr. Belani said.
All patients in the pilot study received chemotherapy and
radiation therapy concomitantly or sequentially. The cohort was 52% male and
48% female with a mean age of 64.5 years. The mean total dose of radiation to
the primary site was 5,712cGy (range: 3,000 to 7,600 cGy). Initially, all
patients received 40,000 IU of epoetin alfa if their hemoglobin levels fell to
or below 11 g/dL. Dr. Belani noted that it was well tolerated.