LUXEMBOURG-Home administration of erythropoietin(Drug information on erythropoietin) (epoetin alfa, Epogen, Procrit) safely prevented or delayed the development of chemotherapy-associated anemia and reduced transfusion requirements by as much as 35% in a multicenter study of patients with small-cell lung cancer (SCLC), Nicholas Thatcher, MD, said at the 7th International Symposium of the Multinational Association of Supportive Care in Cancer (MASCC).
The 130 participants in this multicen-ter prevention trial from the Eprex Anemia Prevention Group all had normal hemoglobin levels prior to their treatment with up to six cycles of intensive, mostly platinum-based chemotherapy, at 3- to 4-week intervals.
SCLC a Model System
They were randomized to receive no erythropoietin, or erythropoietin in a dose of 300 or 150 U/kg subcutaneously three times weekly, starting the day after chemotherapy and continuing until 3 days before the next chemotherapy cycle.
"We can consider SCLC and its chemotherapy a model system for exploring the use of erythropoietin," said Dr. Thatcher of Christie Hospital, Manchester, UK. He told the symposium audience that even prior to chemotherapy, SCLC patients have significantly fewer late and early erythroid progenitors in their bone marrow than do subjects without malignant disease, and are thus especially vulnerable to anemia.
"By the second, third, fourth, and fifth chemotherapy cycles," Dr. Thatcher said, "there was a significant reduction in the percentage of patients who required transfusions, compared with the control group," he said.
Transfusions were necessary in 59% of control patients, but in only 21% of those receiving 300 U/kg of erythropoietin, and in 45% of those on the lower erythropoietin dose.