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According to results recently presented at the 27th annual San Antonio Breast Cancer Symposium (SABCS), Aranesp® significantly improves the quality of life in breast cancer patients with chemotherapy-induced anemia.

Breast cancer is a common cancer among women in the United States, with approximately 250,000 new cases diagnosed every year. Chemotherapy is a mainstay of treatment for breast cancer and is associated with side effects. Depending upon the type of chemotherapy regimen used, chemotherapy-induced anemia may be a common side effect that significantly reduces a patient’s quality of life.

Anemia is a term that refers to low levels of circulating red blood cells (RBCs) in the blood. Red blood cells are responsible for delivering oxygen to tissues throughout the entire body. Bone marrow (spongy material inside large bones) is stimulated to produce RBCs by a chemical substance called erythropoietin, which is produced by the kidneys. Each RBC contains many molecules of hemoglobin, a protein-iron complex that is responsible for the delivery of oxygen to the cells and carbon dioxide to the lungs. Hemoglobin levels are often measured as an indicator of anemia, with levels of less than 12 g/dL being considered a sign of anemia.

Common symptoms caused by anemia include fatigue, shortness of breath, greatly diminished activity levels and a reduced overall feeling of well-being. Severe anemia often necessitates blood transfusions, which have associated risks of infection, rejection and increased medical costs. Furthermore, severe anemia may cause a delay in the dose of cancer treatment, resulting in suboptimal chances of a cure or optimal long-term survival.

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Erythropoietin can be manufactured outside the body and administered to patients. Recombinant human erythropoietin or epoetin alfa, a commonly used drug for cancer patients receiving treatment, is comprised of manufactured erythropoietin. Epoetin alfa has been shown to reduce the severity of anemia and reduce symptoms of fatigue in patients receiving treatment by stimulating the bone marrow to produce more RBCs. [lw1] Currently, Aranesp® and Procrit® are two forms of epoetin alfa most often utilized for the treatment of anemia in the United States. Aranesp®, which requires less frequent dosing than Procrit®, has been approved by the FDA for the treatment of anemia caused by chemotherapy in non-myeloid cancers, or cancers that do not originate in blood cells. Less frequent dosing results in fewer injections and fewer office visits for patients, reducing the need for patients and caregivers to take time off from work or leisure. Furthermore, this allows caregivers to spend less time scheduling appointments and giving inpatient care to treat anemia and more time to attend to other patients and work-related activities. The use of Aranesp® is gaining momentum in the clinical setting as results from clinical trials continue to indicate its effectiveness in comparison to epoetin alfa.

Researchers from the MD Anderson Cancer Center in Texas and the Mt. Sinai Medical Center in New York recently conducted a clinical study to evaluate quality of life in breast cancer patients who were treated with Aranesp®. Patients in this study had chemotherapy-induced anemia, and were treated with Aranesp® every 2 weeks for up to 24 weeks. Patients’ quality of life was assessed according to the MDASI, a tool that analyzes common quality of life issues related to anemia – fatigue, distress, sleep disturbance, lack of appetite, and pain. Approximately 91% of patients responded to treatment with Aranesp® in terms of elevations in their hemoglobin levels. According to results from the MDASI, 94% of patients reported a significant improvement in quality of life once treatment with Aranesp® was initiated and hemoglobin levels rose.

The researchers concluded that treatment with Aranesp® may significantly improve quality of life in breast cancer patients with chemotherapy-induced anemia. Aranesp® is also being evaluated for the prevention of chemotherapy-induced anemia altogether. Patients with anemia who are undergoing treatment may wish to speak with their physician about the risks and benefits of treatment with Aranesp®.

Reference: Cleeland C, Rossi G, Gabrilove J, et al. Assessing symptom burden in breast cancer patients treated with darbepoetin alfa 200 mcg every two weeks (Q2W) using the MD Anderson Symptom Inventory (MDASI). Proceedings from the 27th annual San Antonio Breast Cancer Symposium. December 2004. Abstract #6034.