According to a recent article published in The Oncologist, results from 3 separate trials indicate that dosing every two weeks with Aranesp® is just as effective as weekly dosing with epoetin alfa in reducing chemotherapy-induced anemia.
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 to the lungs.
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, is a commonly used drug for cancer patients receiving treatment and 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. There are currently two forms of epoetin alfa most often utilized for the treatment of anemia in the United States: Aranesp® (darbepoetin alfa) and Procrit® (epoetin alfa). 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 Procrit®.
Results published in The Oncologist were from 3 different trials directly comparing Aranesp® to Procrit® for the treatment of chemotherapy-induced anemia in patients with non-small cell lung cancer (NSCLC), breast cancer, or gynecologic cancer. The trials included 312 patients who had chemotherapy-induced anemia and were treated with either Aranesp® once every 2 weeks, or Procrit® once per week. Over 80% of patients from both groups achieved a correction in anemia as ascertained by hemoglobin levels, while 81% of patients treated with Aranesp® maintained target hemoglobin levels for the remainder of the trial, compared with 75% of patients treated with Procrit®. Blood transfusions were necessary in 16% of patients treated with Aranesp®, and 17% of patients treated with Procrit®. Patients from these trials completed patient questionnaires to assess the impact of treatment for anemia. Patients, on average, reported that treatment for anemia required a total of 4 hours – 2 hours in traveling to and from the clinic and 2 hours at the clinic for treatment. Patients reported that they would have much rather spent that time with family or friends.
The researchers concluded that Aranesp® is as effective as Procrit® at treating chemotherapy induced anemia in patients with various types of cancer. However, Aranesp® requires only half of the dosing as Procrit®, resulting in half of the injections and half of the time spent for treatment of anemia. Patients with chemotherapy-induced anemia and/or those being treated with epoetin alfa may wish to speak with their physician about their individual risks and benefits of treatment with Aranesp®.
Reference: Schwartzberg L, Yee L, Senecal F, et al. A Randomized Comparison of Every-2-Week Darbepoetin Alfa and Weekly Epoetin Alfa for the Treatment of Chemotherapy-Induced Anemia in Patients With Breast, Lung, or Gynecologic Cancer. The Oncologist. 2004;9:696-707.
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