Fixed-Dose Aranesp® as Effective in Anemia as Dose Based on Patient Weight

Cancer Connect

According to a recent article published in Cancer, fixed-dose Aranesp® (darbepoetin alfa) appears as effective as weight-based doses for treating anemia in cancer patients receiving chemotherapy. Fixed doses would provide further convenience to healthcare providers or patients in the administration of Aranesp®.

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, 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. Procrit® is the form of epoetin alfa currently utilized for the treatment of anemia. More recently, however, 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. 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.

Dosing of Aranesp® is currently based on a patients weight, requiring healthcare providers or patients who administer Aranesp® to themselves to prepare and measure the dose prior to each use. Researchers are now evaluating the use of fixed-dose Aranesp®, in which the doses of Aranesp® are all the same and come pre-filled from the manufacturer. Fixed-dose Aranesp® would provide further convenience compared to weight-based dosing, as it would eliminate the need for measurement prior to administration, as well as reduce the risk of incorrect dosing. Researchers affiliated with a Darbepoetin Alfa Study Group recently conducted a clinical trial to compare the effectiveness of fixed-dose Aranesp® to weight-based dosing of Aranesp®. This trial included 242 patients who had non-myeloid cancer and were being treated with chemotherapy. All patients received Aranesp®, and were treated with either a fixed-dose of Aranesp® (325 micrograms), or a dose based on their weight (4.5 micrograms per kilogram). Results indicated that both dosing regimens provided equivalent effectiveness in correcting anemia in these patients, with fixed-dosing providing increased convenience compared to weight-based dosing.

The researchers concluded that fixed-dose Aranesp® corrects anemia as effectively as weight-based dosing of Aranesp® in patients with cancer who are being treated with chemotherapy. Fixed-dose Aranesp® provides further convenience, as the measurement of doses is eliminated for patients or healthcare providers. Patients may wish to ask their physician about the risks and benefits of participating in a clinical trial further evaluating fixed-dose Aranesp®, or other novel supportive care measures. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.cancerconsultants.com. Personalized clinical trial searches are also performed on behalf of patients at cancerconsultants.com.

Reference: A Randomized Controlled Trial of Darbepoietin Alfa Administered as a Fixed Or Weight-Based Dose Using a Front-Loading Schedule in Patients with Anemia who have Non-Myeloid Malignancies.

Cancer. 2004;100:859-868.

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