Berlin, 22 September 2009 - Adherence to new international guidelines on the use of erythropoiesis stimulating agents (ESAs) in the management of chemotherapy-induced anaemia (CIA) can improve the quality of life of cancer patients, while minimising the risks of ESA side effects.
Speakers at the Hospira-sponsored symposium at the Joint ECCO 15/34th ESMO Congress in Berlin, Germany, urged colleagues to stick to the revised haemoglobin thresholds recommended in the guidelines,1,2 and target ESA treatment at those cancer patients undergoing chemotherapy who have been shown to gain most benefit.
“International guidelines now recommend initiating ESA treatment in patients with haemoglobin levels less than 10g/dL and to stop once they have become transfusion independent or when their haemoglobin levels reach 12 g/dL. If oncologists follow these recommendations in whichever country they practise, I am confident that we will see lower levels of the venous thromboembolic events reported with ESAs in earlier trials,” explained Dr Jim Janinis, Director of the Department of Medical Oncology, Athens Medical Center, Athens, Greece.
Dr Janinis presented data from three meta-analyses of ESA studies, which linked increased rates of venous thromboembolic events (VTEs) with reduced survival.3-5 However he commented that “In many of the trials evaluated, ESA treatment had been initiated at relatively high baseline haemoglobin levels of 11-12 g/dL and continued until patients achieved target levels of 14-15 g/dL. More controlled use of ESAs, in line with the new international guidelines, would have beneficial effects on mortality as well as VTE risk.”
Two thirds of delegates using biosimilar ESA
Sixty eight per cent of delegates attending the symposium reported that their clinics were now using biosimilar ESA6, according to results of interactive questions posed by Professor Stefan Frühauf, from the Department of Hematology/Oncology at the Center for Tumor Diagnostics and Therapy, Osnabrück, Germany. During a case study discussion of optimal ESA use in clinical practice, Professor Frühauf explained that appropriate CIA management was an important part of supportive care, which could significantly impact on patients’ quality of life. He commented that his clinical experience has shown the biosimilar ESA, epoetin zeta (Retacrit®), to be effective and well tolerated by patients.
Latest clinical trial data on epoetin zeta, presented at the symposium, confirmed its tolerability and efficacy in the management of CIA, adding to existing data demonstrating comparable biological activity, dose and haemoglobin response.
“The use of biosimilars, such as Retacrit, is increasing, and offers greater access to treatment. Switching to epoetin zeta presents no problem to the oncologist or the patient, and the efficacy and tolerability of treatment is well maintained,” concluded symposium chairman, Dr Paris Kosmidis, from Hygeia Hospital, Athens, Greece.
For further information, please contact: Sarah Tomlinson, Athena Medical PR
Tel: +44 (0) 20 8956 2871 / Mob: +44 (0) 7739 798155 Email: saraht@athenamedicalpr.com
Hannah Stacey, Athena Medical PR Tel: +44 (0) 20 8956 2289 / Mob: +44 (0) 7984 496441 Email: hannah@athenamedicalpr.com
References
1. Aapro MS, Link H. September 2007 Update on EORTC Guidelines and Anemia Management with Erythropoiesis-Stimulating Agents. The Oncologist 2008; 13 (suppl 3): 33-36
2. Rizzo JD, Somerfield MR, Hagerty KL et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update. Blood. 2008; 111(1): 25-41
3. Bennett CL, Silver SM, Djulbegovic B et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer-associated anemia. JAMA. 2008; 299(8): 914-24
4. Bohlius J, Schmidlin K, Brillant C et al. Recombinant human erythropoiesis-stimulating agents and mortality in patients with cancer: a meta-analysis of randomised trials. Lancet. 2009 May 2; 373(9674):1532-42
5. Tonelli M, Hemmelgarn B, Reiman T et al. Benefits and harms of erythropoiesis-stimulating agents for anemia related to cancer: a meta-analysis. CMAJ. 2009 May 26; 180(11): E62-71
6. Data on file
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