SAN FRANCISCONovel erythropoiesis stimulating protein (NESP, darbepoetin-alfa, Aranesp) is an investigational recombinant erythropoietic protein that binds to the erythropoietin(Drug information on erythropoietin) receptor and stimulates erythropoiesis by the same mechanism as recombinant human erythropoietin (epoetin alfa, Procrit, Epogen).
NESP has a serum half-life of more than 40 hours in cancer patients receiving chemotherapy, approximately three times longer than epoetin. Thus, NESP can be given once a week or once every 2 weeks, compared with three times a week for epoetin alfa(Drug information on epoetin alfa).
Poster presentations at the 37th Annual Meeting of the American Society of Clinical Oncology (ASCO) showed that NESP can correct disease-related and treatment-induced anemias in cancer patients, and can reduce the need for transfusions in lung cancer patients being treated with platinum-based regimens.
Preliminary studies also showed that NESP could increase hemoglobin levels in patients with lymphoproliferative malignancies, with solid tumors being treated with chemotherapy, and with non-myeloid malignancies being treated with chemotherapy.
Platinum Therapy in Lung Cancer
Robert Pirker, MD, reported a phase III, double-blind, placebo-controlled, randomized study of NESP in patients undergoing platinum treatment for lung cancer (abstract 1572). Dr. Pirker, of the University of Vienna Medical School, Vienna, Austria, reported the results on behalf of the NESP 980297 Study Group.
In this study, 320 anemic patients (hemoglobin 11 g/dL or less) were randomized to receive NESP 2.25 µg/kg or placebo. Study drug was administered subcutaneously once weekly for a maximum of 12 weeks and was withheld if hemoglobin concentrations were 14 g/dL (for women) or 15 g/dL (for men). The study dose was doubled if, at week 6, hemoglobin had not increased by at least 1 g/dL.