Author | A. Oliver Sartor, MD

Articles

ASCO Preview: Cabazitaxel, Survival Surrogate Endpoints in Prostate Cancer

June 01, 2016

In this interview ahead of the 2016 ASCO Annual Meeting we discuss some of the prostate cancer trials to watch out.

Radium-223 in Bone-Metastatic Prostate Cancer: Current Data and Future Prospects

July 15, 2015

This article will describe the historic background of Ra-223; outline the clinical studies which led to phase III trials of this agent; highlight key results of these phase III studies; and explore possible future directions for use of Ra-223 and other alpha particles-both in prostate cancer and for management of other diseases.

Surveillance for Prostate Cancer: Are the Proceduralists Running Amok?

June 15, 2013

In my experience, being treated for low-volume Gleason 6 tumors is the norm, not the exception, for men in the United States. Surveillance may be discussed as an option, but it is not taken seriously.

Reassessments of ESAs for Cancer Treatment in the US and Europe

March 15, 2010

Anemia is a widely prevalent complication among cancer patients. At the time of diagnosis, 30% to 40% of patients with non-Hodgkin lymphoma or Hodgkin lymphoma and up to 70% of patients with multiple myeloma are anemic; rates are higher among persons with myelodysplastic syndromes. Among patients with solid cancers or lymphomas, up to half develop anemia following chemotherapy. For almost 2 decades, erythropoiesis-stimulating agents (ESAs) were the primary treatment for cancer-related anemia. However, reassessments of benefits and risks of ESAs for cancer-associated anemia have occurred internationally. We reviewed guidelines and notifications from regulatory agencies and manufacturers, reimbursement policies, and utilization for ESAs in the cancer and chronic kidney disease settings within the United States, Europe, and Canada. In 2008 the US Food and Drug Administration (FDA) restricted ESAs from cancer patients seeking cure. Reimbursement is limited to hemoglobin levels < 10 g/dL. In the United States, ESA usage increased 340% between 2001 and 2006, and decreased 60% since 2007. The European Medicines Agency (EMEA) recommended that ESA benefits do not outweigh risks. In Europe between 2001 and 2006, ESA use increased 51%; since 2006, use decreased by 10%. In 2009, Canadian manufacturers recommended usage based on patient preferences. In Canada in 2007, approximately 20% of anemic cancer patients received ESAs, a 20% increase since 2004. In contrast to Europe, where ESA use has increased over time, reassessments of ESA-associated safety concerns in the United States have resulted in marked decrements in ESA use among cancer patients.