Epoetin May Improve Survival in Patients with Esophageal Cancer
According to an article recently published in the International Journal of Radiation Oncology Biology, and Physics, the use of epoetin alfa to prevent or reduce anemia is associated with improved survival for patients with stage III esophageal cancer who are treated with chemotherapy and radiation therapy.
The esophagus is a muscular tube that carries food from the mouth to the stomach. Patients with stage III esophageal cancer have cancer that invades through the wall of the esophagus and has spread to the lymph nodes and/or invaded adjacent structures; many esophageal cancer patients are diagnosed at this stage of disease. Stage III cancer may also be referred to as locally advanced.
Anemia is a common adverse effect caused by some chemotherapy regimens, radiation therapy, and sometimes by the cancer itself. It is characterized by low levels of circulating red blood cells, which are responsible for delivering oxygen to tissues throughout the body.
Common symptoms of anemia are severe fatigue, shortness of breath, diminished activity levels, and a reduced overall feeling of well-being.
Severe anemia often requires treatment with blood transfusions, which have associated risks of infection, rejection, and increased medical costs. Furthermore, severe anemia may cause a delay in cancer treatment, resulting in suboptimal chances of a cure or optimal long-term survival.
Treatment of anemia with medications that stimulate the production of red blood cells (erythropoietic treatment) has been shown to have several benefits in cancer patients, including increased quality of life and decreased need for blood transfusions. These medications include Aranesp® (darbepoetin alfa) and Procrit® (epoetin alfa).
Researchers from Germany recently provided follow-up data of a study that evaluated the effects of epoetin alfa and outcomes of patients with stage III esophageal cancer. This study included 96 patients who were treated with chemotherapy (5-fluorouracil and Platinol® [cisplatin]) and radiation therapy followed by surgery. A total of 42 patients received epoetin alfa to maintain hemoglobin levels of 12-14 g/dL; 54 patients did not receive epoetin alfa (control group).
At two years 67% of patients treated with epoetin alfa did not experience cancer progression at or near the site of origin compared with only 15% of the control group.
Overall survival at two years was 32% for those treated with epoetin alfa compared with only 8% in the control group.
The researchers concluded that use of epoetin alfa in patients with esophageal cancer undergoing chemotherapy and radiation therapy was associated with a reduced risk of cancer progression near the site of cancer origin, as well as improved overall survival. Further study is necessary to confirm these findings.
Patients with esophageal cancer who are to undergo treatment with chemotherapy and radiation therapy may wish to speak with their physician regarding their individual risks and benefits of treatment with epoetin alfa or Aranesp®.
Reference: Rades D, Tribius S, Yekebas EF, et al. Epoetin alfa improves survival after chemoradiation for stage III esophageal cancer: Final results of a prospective observational study. International Journal of Radiation Oncology Biology Physics. 2006;65:459-465.
The esophagus is a muscular tube that carries food from the mouth to the stomach. Patients with stage III esophageal cancer have cancer that invades through the wall of the esophagus and has spread to the lymph nodes and/or invaded adjacent structures; many esophageal cancer patients are diagnosed at this stage of disease. Stage III cancer may also be referred to as locally advanced.
Anemia is a common adverse effect caused by some chemotherapy regimens, radiation therapy, and sometimes by the cancer itself. It is characterized by low levels of circulating red blood cells, which are responsible for delivering oxygen to tissues throughout the body.
Common symptoms of anemia are severe fatigue, shortness of breath, diminished activity levels, and a reduced overall feeling of well-being.
Severe anemia often requires treatment with blood transfusions, which have associated risks of infection, rejection, and increased medical costs. Furthermore, severe anemia may cause a delay in cancer treatment, resulting in suboptimal chances of a cure or optimal long-term survival.
Treatment of anemia with medications that stimulate the production of red blood cells (erythropoietic treatment) has been shown to have several benefits in cancer patients, including increased quality of life and decreased need for blood transfusions. These medications include Aranesp® (darbepoetin alfa) and Procrit® (epoetin alfa).
Researchers from Germany recently provided follow-up data of a study that evaluated the effects of epoetin alfa and outcomes of patients with stage III esophageal cancer. This study included 96 patients who were treated with chemotherapy (5-fluorouracil and Platinol® [cisplatin]) and radiation therapy followed by surgery. A total of 42 patients received epoetin alfa to maintain hemoglobin levels of 12-14 g/dL; 54 patients did not receive epoetin alfa (control group).
At two years 67% of patients treated with epoetin alfa did not experience cancer progression at or near the site of origin compared with only 15% of the control group.
Overall survival at two years was 32% for those treated with epoetin alfa compared with only 8% in the control group.
The researchers concluded that use of epoetin alfa in patients with esophageal cancer undergoing chemotherapy and radiation therapy was associated with a reduced risk of cancer progression near the site of cancer origin, as well as improved overall survival. Further study is necessary to confirm these findings.
Patients with esophageal cancer who are to undergo treatment with chemotherapy and radiation therapy may wish to speak with their physician regarding their individual risks and benefits of treatment with epoetin alfa or Aranesp®.
Reference: Rades D, Tribius S, Yekebas EF, et al. Epoetin alfa improves survival after chemoradiation for stage III esophageal cancer: Final results of a prospective observational study. International Journal of Radiation Oncology Biology Physics. 2006;65:459-465.
posted by TM at 2:34 PM
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