Recent results presented at the 37th American Society of Clinical Oncology meeting, indicate that darbepoetin alfa, or novel erythropoiesis stimulating protein (NESP), reduces the incidence of anemia and/or hastens recovery from anemia in cancer patients with minimal inconvenience to patients.

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.

Cancer patients, particularly those receiving chemotherapy, 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, intolerance and increased medical costs. In addition, anemia can delay the administration of treatment or cause dose reductions, impeding optimal treatment benefits.

Erythropoietin can be manufactured outside the body and administered to patients. Recombinant human erythropoietin (rHuEPO), a commonly used drug for cancer patients receiving treatment, is comprised of manufactured erythropoietin. It has been shown to reduce the severity of anemia and reduce symptoms of fatigue in patients by stimulating the bone marrow to produce more RBCs. rHuEPO is administered daily or three times a week for the treatment of chemotherapy induced anemia.

Recently, researchers have developed NESP, a new form of erythropoietin that stimulates production of RBCs in the same manner as erythropoietin, and may only need to be administered once every two to three weeks. Modifications have been made to the structure of NESP so that it stimulates erythropoiesis at a greater rate than rHuEPO. In addition, NESP has been developed so that one dose remains active in the patient’s system longer than one dose of rHuEPO (JASN, 1999). This allows for less frequent dosing while maintaining benefits of the medication. In essence, patients may be able to avoid several trips to the physician and receive fewer subcutaneous injections.

A recent clinical study evaluating the use of NESP involved over 300 patients with lung cancer who were being treated with platinum chemotherapy (carboplatin or cisplatin). Half of the patients received NESP once every three weeks during treatment and the other half received a placebo. Patients receiving NESP had a significantly lower incidence and/or severity of anemia compared to those receiving placebo. Only 21% of patients receiving NESP required a blood transfusion during treatment compared with 51% of patients receiving placebo. The average number of hospitalization days during treatment was 13.5 for patients receiving NESP and 17.7 for patients receiving placebo. Additionally, patients receiving NESP reported a higher quality of life compared to those receiving placebo.

These results indicate that NESP reduces the severity and incidence of anemia in cancer patients receiving chemotherapy, ultimately reducing blood transfusions, allowing optimal treatment schedules and enhancing a patient’s quality of life. Moreover, the administration regimen of only once every three weeks should facilitate patient compliance with treatment schedules.

Patients receiving chemotherapy may wish to speak with their physician about the use of NESPor the risks and benefits of participating in a clinical trial further evaluating NESP or other supportive care measures. Two sources of ongoing information regarding clinical trials includes comprehensive, easy-to-use listing services provided by The National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients. (37th annual meeting of the American Society of Clinical Oncology, San Francisco, CA, abstract 1572, 2001)

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