1. ¹Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, 1, route du Muids, Genolier CH-1272, Switzerland
2. ²F Hoffmann-La Roche Ltd, Basel CH-4070, Switzerland

Correspondence: Dr M Aapro, E-mail: MAAPRO@genolier.net

Received 14 January 2008; Revised 9 April 2008; Accepted 15 April 2008; Published online 10 June 2008.

Abstract

Epoetin- is used to treat patients with metastatic cancer undergoing chemotherapy to alleviate the symptoms of anaemia, reduce the risk of blood transfusions and improve quality of life. This meta-analysis of 12 randomised, controlled studies evaluated the impact of epoetin- on overall survival, tumour progression and thromboembolic events (TEEs). A total of 2297 patients were included in the analysis (epoetin-, n=1244; control, n=1053; 65% solid and 35% nonmyeloid haematological malignancies). A prespecified subgroup analysis assessed the effects in patients with a baseline Hb11 g dl^-1, corresponding to current European Organisation for Research and Treatment of Cancer (EORTC) guidelines. No statistically significant effect on mortality was observed with epoetin- vs control, both overall (hazard ratio (HR)=1.13; 95% CI: 0.87, 1.46; P=0.355) and in patients with baseline Hb11 g dl^-1 (HR=1.09; 95% CI: 0.80, 1.47; P=0.579). A trend for a beneficial effect on tumour progression was seen overall (HR=0.85; 95% CI: 0.72, 1.01; P=0.072) and in patients with an Hb11 g dl^-1 (HR=0.80; 95% CI: 0.65, 0.99; P=0.041). An increased frequency of TEEs was seen with epoetin- vs control (7 vs 4% of patients); however, TEEs-related mortality was similar in both groups (1% each). The results of this meta-analysis indicate that when used within current EORTC treatment guidelines, epoetin- has no negative impact on survival, tumour progression or TEEs-related mortality.