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VTE and mortality associated with erythropoiesis-stimulating agents in cancer-associated anemia

Nature Clinical Practice Oncology volume 5, pages 504–505 (2008)Cite this article

Abstract

This Practice Point commentary examines a recent systematic review by Bennett et al. that summarized 51 controlled trials of the erythropoiesis-stimulating agents (ESAs) darbepoetin and epoetin in patients with cancer. The review focused exclusively on the safety of this class of drugs. Key findings included an increased risk of venous thromboembolism (previously reported) and poorer overall survival (a new finding) in patients who received ESAs, compared with controls. This commentary discusses the evolving safety concerns regarding ESAs, and highlights the uncertainties about which groups of patients are at risk and whether some administration strategies are safer than others. The regulatory and reimbursement environments for these compounds are in flux, and until additional data are available, a conservative treatment approach is appropriate.

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References

  1. Bennett CL et al. (2008) Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia. JAMA 299: 914–924

    Article  CAS  Google Scholar 

  2. Rizzo JD et al. (2008) Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update. J Clin Oncol 26: 132–149

    Article  CAS  Google Scholar 

  3. Bohlius J et al. Erythropoietin or darbepoetin for patients with cancer. Cochrane Database Systematic Reviews 2006 Issue 2 Art No.: CD003407. DOI: 10.1002/14651858.CD003407.pub4

  4. Wilson J et al. (2007) A systematic review and economic evaluation of epoetin alpha, epoetin beta and darbepoetin alpha in anaemia associated with cancer, especially that attributable to cancer treatment. Health Technol Assess 11: 1–202, iii–iv

    Article  CAS  Google Scholar 

  5. FDA (online 13 March 2008) FDA briefing document. Oncologic Drugs Advisory Board. [http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4345b2-01-FDA.pdf] (accessed 24 April 2008)

  6. Phurrough S et al. (2007) Decision memo for erythropoiesis stimulating agents (ESAs) for non-renal disease indications (CAG-00383N). [https://www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2= viewdecisionmemo.asp&id=203&] (accessed 24 April 2008)

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Authors and Affiliations

  1. and DP Steensma is Associate Professor of Medicine and Oncology and Consultant in the Division of Hematology, RS Dronca is a Senior Fellow in Hematology and Medical Oncology, at the Mayo Clinic, Rochester, MN, USA.,

    Roxana S Dronca & David P Steensma

Authors
  1. Roxana S Dronca
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  2. David P Steensma
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Corresponding author

Correspondence to David P Steensma.

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The authors declare no competing financial interests.

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Dronca, R., Steensma, D. VTE and mortality associated with erythropoiesis-stimulating agents in cancer-associated anemia. Nat Rev Clin Oncol 5, 504–505 (2008). https://doi.org/10.1038/ncponc1202

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