According to results presented at the 27th Annual Meeting of the European Society of Medical Oncology, clinical trial results confirm that early intervention for anemia improves overall quality of life and reduces the need for blood transfusions in patients receiving treatment for breast cancer.

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 secreted 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 away from the lungs.

Cancer patients, particularly those receiving chemotherapy and/or radiation, often suffer from anemia. Common symptoms caused by anemia include severe 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.

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. Historically, Procrit® was the form of epoetin alfa utilized for the treatment of anemia. However, more recently the agent Aranesp®, which requires significantly less dosing than Procrit®, has been approved by the FDA for the treatment of anemia caused by chemotherapy in the treatment of cancer.

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Although there are general guidelines for administration of epoetin alfa in the treatment of anemia, the optimal timing of the deliverance is still being evaluating in clinical trials. Recently, researchers from Italy conducted a clinical trial comparing epoetin alfa and best supportive care (control group) for up to 24 weeks on chemotherapy and for 4 weeks after the discontinuation of chemotherapy in 223 women with breast cancer. Blood transfusions were given to 6.7% of patients treated with epoetin alfa, compared to 16.9% of patients in the control group. Overall well being and quality of life was significantly improved in the group of patients treated with epoetin alfa, compared to the control group.

These researchers concluded that these results confirm early treatment with epoetin alfa appears to improve quality of life and reduce the need for blood transfusions in women receiving adjuvant chemotherapy for breast cancer. Patients diagnosed with breast cancer who are to receive chemotherapy may wish to discuss the risks and benefits of epoetin alfa with their physicians or the participation in a clinical trial further evaluating supportive care measures. Two sources of information regarding ongoing clinical trials include the National Cancer Institute ( and also provides personalized clinical trial searches on behalf of patients.

Reference: Pronzato P, Cortesi E, van der Rijt C, et al. Early intervention with epoetin alfa in breast cancer (BC) patients (pts) undergoing chemotherapy (CT): Results of a randomized, multicenter, phase IIIb study (EPO-INT-47 Study Group).

Annals of Oncology. 2002; 13 (Suppl. 5):168. Abstract 6200. Proceedings from the twenty seventh annual meeting of the European Society of Medical Oncology, October 2002.

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