LOS ANGELESProgress in treating cancer-related anemia has accelerated
in the almost 20 years since the human erythropoietin gene was cloned. That
was in 1983. Ten years later, the Food and Drug Administration approved
epoetin alfa (Epogen, Procrit) for transfusion-preventing treatment of
patients with anemia-complicating therapy.
Target hemoglobin levels "have been increasing as we get out of the
transfusion age into the erythropoietic therapy age, and the perceived
benefits in clinical trials have been increasing at the same time,"
reported John Glaspy, MD, MPH. He predicted that as new data emerge,
"we are going to be able to demonstrate that normalizing hemoglobin is
associated with improvements in other endpoints beyond quality of life,
including survival in cancer patients and disease progression in patients
with other chronic inflammatory diseases."
Dr. Glaspy is medical director of the Boyer Oncology Clinic and professor
of medicine at the University of California School of Medicine in Los
Angeles. He served as co-chair of the Fifth Quality of Life in Oncology
"Much of our current knowledge of the biological and clinical
significance of erythropoiesis grew out of research on patients with renal
failure," Dr. Glaspy noted. "This is a much simpler model of
anemia than cancer is, and it has given us incredible insights,"
although too often these have been ignored.
Cancer Patients Benefit
Since 2000, more attention has been focused on cancer-related anemia and
its effect on patients’ quality of life. Studies, including controlled
trials, ultimately demonstrated that cancer patients receiving human
recombinant erythropoietin (rHuEPO) had improved quality of life and
Supporting data from three community-based studies show cumulative
increases in the linear analogue self-assessment (LASA) QOL score over time
as hemoglobin levels rise from 7 to 13 or 14 g/dL in patients treated with
erythropoietic therapy. "Unlike what we in cancer research thought was
the case, there appears to be a continued gain as we go from 10 to 13 g/dL,"
Dr. Glaspy noted.