SAN FRANCISCOAnemic breast cancer patients receiving
chemoradiotherapy who are also treated with weekly recombinant human
erythropoietin (epoetin alfa [Procrit, Eprex, Erypo]) have not only better
hemoglobin levels but also improved energy, activity levels, and overall
quality of life.
According to a retrospective subgroup analysis, mean hemoglobin
levels in treated patients increased from 10.1 g/dL at baseline to 12.6 g/dL, a
mean change of 2.5 g/dL (P < 0.05). In patients with two or more
quality-of-life assessments (n = 62), significant (P < 0.05)
improvements from baseline to final assessment were observed.
Linda T. Vahdat, MD, told Oncology News International that the analysis showed
that epoetin alfa was as effective in anemic breast cancer patients receiving
both radiation and chemotherapy as had previously been observed in patients
receiving chemotherapy alone. She said that similar results have been seen in
patients with other types of cancer. Dr. Vahdat is with the Division of Medical
Oncology, College of Physicians and Surgeons of Columbia University, New York
The breast cancer subgroup analysis was drawn from a
multicenter, open-label, nonrandomized, 16-week study of epoetin alfa in
patients with hemoglobin of 11 g/dL or less that were receiving concomitant or
sequential radiation and chemotherapy. Monthly assessments included clinical
response, hemoglobin levels, transfusion requirements, and incidence/severity
of adverse events.
At baseline and at weeks 8 and 16, patient-reported energy,
activity, and overall quality of life were measured by 100-mm Linear Analog
Scale Assessment tool. The retrospective subanalysis included 64 evaluable
patients with breast cancer. Of these, 51 (80%) received concomitant
chemotherapy/radiotherapy and epoetin alfa. In 23 patients (36%), radiation was
to the breast only, and 41 (64%) received radiation to the breast and to one or
more other sites. Mean radiation dose to the primary site was 5,390 cGy (range:
2,880 to 6,600 cGy).
Response was defined as a hemoglobin increase of 2 or more g/dL
or attaining a hemoglobin level of at least 12 g/dL. The response rate was 91%.
The researchers reported that 33% of patients required dose escalation from
40,000 U per week to 60,000 U per week.
Hemoglobin increases were independent of chemotherapy regimen,
which included platinum-based regimens, taxane-based regimens, or
"I think the barriers to widespread use of epoetin alfa
have slowly decreased and that hemoglobin maintenance is now becoming standard
of care for management of breast cancer patients being treated with
chemoradiation," Dr. Vahdat said.