Skip to main content
SpringerLink
Log in

Early intervention with epoetin beta prevents severe anaemia in patients with solid tumours receiving platinum-based chemotherapy: results of the NeoPrevent study

  • Original Article
  • Published:
Cancer Chemotherapy and Pharmacology Aims and scope Submit manuscript

Abstract

Background

Anaemia is common during platinum-based chemotherapy. This study aimed to evaluate the efficacy and safety of epoetin beta in the prevention of severe anaemia in patients with solid tumours receiving concomitant platinum therapy.

Patients and methods

In this open-label, single-arm study, patients (n = 255) with solid tumours and haemoglobin (Hb) levels ≤ 13 g/dl (men) or ≤ 12 g/dl (women) received epoetin beta 450 IU/kg (∼30,000 IU) weekly until 4 weeks after their last platinum-based chemotherapy cycle.

Results

An anaemia prevention response [defined as patients with a Hb response (increase in Hb level > 1 g/dl from baseline) plus patients whose Hb levels remained ± 1 g/dl of baseline throughout the study] was observed in 234 patients (92%). Response to epoetin beta was rapid. Of the 159 patients achieving a Hb response, 139 (87%) had Hb levels > 1 g/dl of baseline within 4 weeks of treatment initiation. Mean Hb levels had improved from 10.8 ± 1.0 g/dl at baseline to 12.2 ± 1.8 g/dl by the final visit. Quality of life measured by linear analogue scale assessment significantly (P < 0.01) improved in patients achieving a Hb response (n = 159).

Conclusions

Epoetin beta effectively prevents anaemia in most patients with solid tumours receiving concurrent platinum-based chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Groopman JE, Itri LM (1999) Chemotherapy-induced anemia in adults: incidence and treatment. J Natl Cancer Inst 91:1616–1634

    Article  PubMed  CAS  Google Scholar 

  2. Ludwig H, Van Belle S, Barrett-Lee P et al (2004) The European Cancer Anaemia Survey (ECAS): a large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer 40:2293–2306

    Article  PubMed  Google Scholar 

  3. Langer CJ, Choy H, Glaspy JA, Colowick A (2002) Standards of care for anemia management in oncology. Focus on lung cancer. Cancer 95:613–623

    Article  PubMed  Google Scholar 

  4. Cella D (1998) Factors influencing quality of life in cancer patients: anemia and fatigue. Semin Oncol 25(Suppl 7):43–46

    PubMed  CAS  Google Scholar 

  5. Caro JJ, Salas M, Ward A, Goss G (2001) Anemia as an independent prognostic factor for survival in patients with cancer: a systematic, quantitative review. Cancer 91:2214–2221

    Article  PubMed  CAS  Google Scholar 

  6. MacRae R, Shyr Y, Johnson D, Choy H (2002) Declining hemoglobin during chemoradiotherapy for locally advanced non-small cell lung cancer is significant. Radiother Oncol 64:37–40

    Article  PubMed  CAS  Google Scholar 

  7. Albain KS, Crowley JJ, LeBlanc M, Livingston RB (1991) Survival determinants in extensive-stage non-small-cell lung cancer: the Southwest Oncology Group experience. J Clin Oncol 9:1618–1626

    PubMed  CAS  Google Scholar 

  8. Nisman B, Barak V, Hubert A et al (2003) Prognostic factors for survival in metastatic breast cancer during first-line paclitaxel chemotherapy. Anticancer Res 23:1939–1942

    PubMed  Google Scholar 

  9. Dunst J, Kuhnt T, Strauss HG et al (2003) Anemia in cervical cancers: impact on survival, patterns of relapse, and association with hypoxia and angiogenesis. Int J Radiat Oncol Biol Phys 56:778–787

    Article  PubMed  Google Scholar 

  10. Jelkmann W (2004) Molecular biology of erythropoietin. Intern Med 43:649–659

    Article  PubMed  CAS  Google Scholar 

  11. Österborg A, Brandberg Y, Molostova V et al (2002) Randomized, double-blind, placebo-controlled trial of recombinant human erythropoietin, epoetin beta, in hematologic malignancies. J Clin Oncol 20:2486–2494

    Article  PubMed  Google Scholar 

  12. Glimelius B, Linne T, Hoffman K et al (1998) Epoetin beta in the treatment of anemia in patients with advanced gastrointestinal cancer. J Clin Oncol 16:434–440

    PubMed  CAS  Google Scholar 

  13. Bogdanos J, Karamanolakis D, Milathianakis K et al (2004) Epoetin beta (NeoRecormon®) corrects anaemia in patients with hormone-refractory prostate cancer and bone metastases. Anticancer Res 24:1957–1962

    PubMed  CAS  Google Scholar 

  14. Boogaerts M, Coiffier B, Kainz C (2003) Epoetin β QOL working group. Impact of epoetin β on quality of life in patients with malignant disease. Br J Cancer 88:988–995

    Article  PubMed  CAS  Google Scholar 

  15. Kunikane H, Watanabe K, Fukuoka M et al (2001) Double-blind randomized control trial of the effect of recombinant human erythropoietin on chemotherapy-induced anemia in patients with non-small cell lung cancer. Int J Clin Oncol 6:296–301

    Article  PubMed  CAS  Google Scholar 

  16. ten Bokkel Huinink WW, de Swart CA, van Toorn DW et al (1998) Controlled multicentre study of the influence of subcutaneous recombinant human erythropoietin on anaemia and transfusion dependency in patients with ovarian carcinoma treated with platinum-based chemotherapy. Med Oncol 15:174–182

    PubMed  CAS  Google Scholar 

  17. Crawford J, Robert F, Perry M et al (2003) Epoetin alfa 40,000 u once weekly maintains hemoglobin in advanced non-small-cell lung cancer patients receiving first-line chemotherapy (Abstract 2527). Proc Am Soc Clin Oncol 22:628

    Google Scholar 

  18. Thatcher N, De Campos ES, Bell DR et al (1999) Epoetin alpha prevents anaemia and reduces transfusion requirements in patients undergoing primarily platinum-based chemotherapy for small cell lung cancer. Br J Cancer 80:396–402

    Article  PubMed  CAS  Google Scholar 

  19. Del Mastro L, Venturini M, Lionetto R et al (1997) Randomized phase III trial evaluating the role of erythropoietin in the prevention of chemotherapy-induced anemia. J Clin Oncol 15:2715–2721

    PubMed  Google Scholar 

  20. Henry DH, Brooks BJ Jr, Case DC Jr et al (1995) Recombinant human erythropoietin therapy for anemic cancer patients receiving cisplatin chemotherapy. Cancer J Sci Am 1:252

    PubMed  CAS  Google Scholar 

  21. Bokemeyer C, Aapro MS, Courdi A et al (2004) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer. Eur J Cancer 40:2201–2216

    Article  PubMed  CAS  Google Scholar 

  22. Cazzola M, Beguin Y, Kloczko J et al (2003) Once-weekly epoetin beta is highly effective in treating anaemic patients with lymphoproliferative malignancy and defective endogenous erythropoietin production. Br J Haematol 122:386–393

    Article  PubMed  CAS  Google Scholar 

  23. Leonard R, Aapro M, Chan S et al (2004) Once weekly epoetin beta in patients with metastatic breast cancer receiving anthracycline- or taxane-based chemotherapy. Ann Oncol 15(Suppl 3): (Abstract 188P)

  24. Leyland-Jones B (2003) Breast cancer trial with erythroprotein terminated unexpectedly. Lancet Oncol 4:459–460

    Article  PubMed  Google Scholar 

  25. Henke M, Laszig R, Rube C et al (2003) Erythropoietin to treat head and neck cancer patients with anaemia undergoing radiotherapy: randomised, double-blind, placebo-controlled trial. Lancet 362:1255–1260

    Article  PubMed  CAS  Google Scholar 

  26. Aapro M et al (2004) Effect of epoetin beta on tumour progression and survival in patients with cancer: a meta-analysis of controlled clinical studies. Ann Oncol 15 (Suppl 3): (Abstract 841P)

  27. Bohlius J, Langensiepen S, Schwarzer G et al (2005) Recombinant human erythropoietin and overall survival in cancer patients: results of a comprehensive meta-analysis. J Natl Cancer Inst 97:489–498

    Article  PubMed  CAS  Google Scholar 

  28. Coiffier B, Boogaerts M, Aapro M et al (2004) Thrombo-embolic events in patients with cancer treated with NeoRecormon® (epoetin beta): a meta-analysis of controlled trials. ESMO (Abstract)

  29. Crawford J, Cella D, Cleeland CS et al (2002) Relationship between changes in hemoglobin level and quality of life during chemotherapy in anemic cancer patients receiving epoetin alfa therapy. Cancer 95:888–895

    Article  PubMed  CAS  Google Scholar 

  30. Henry DH (2005) Epoetin alfa for the treatment of cancer- and chemotherapy-related anaemia: product review and update. Expert Opin Pharmacother 6:295–310

    Article  PubMed  CAS  Google Scholar 

  31. Barrett-Lee PJ, Ludwig H, Bokemeyer C et al (2003) Independent risk factors for anemia in cancer (CA) patients (pts) are defined by logistic regression modeling: results from the European Cancer Anaemia Survey (ECAS) (Abstract 2946). Proc Am Soc Clin Oncol 22:733

    Google Scholar 

Download references

Acknowledgments

The authors thank the staff at participating centres and the following investigators who collaborated in the study: Dr. A. Abad, Hospital Germans Trias I Pujol, Barcelona; Dr. A. Velasco, Hospital de la Princesa, Madrid; Dr. M. Domine, Fudación Jiménez Díaz, Madrid; Dr. J. Dorta, Hospital Ntra. Sra. Candelaria, Tenerife; Dr. Batiste-Alentorn, Hospital de Vic, Vic; Dr. Gúrpide, Clínica Universitaria de Navarra, Pamplona; Dr. Arrivi, Hospital Son Llatzer, P de Mallorca; Dr. Frau, Hospital Provincial, Castellón; Dr. Barrajón, Hospital de Elche, Alicante; Dr. I Maestu and Dr. R. Llorente, Hospital Virgen de los Lirios, Alcoy. This study was supported by Roche Farma S.A, Spain.

Author information

Authors and Affiliations

  1. Servicio de Oncología Médica, Hospital Universitario La Paz (Madrid), Paseo de la Castellana, 261, 28046, Madrid, Spain

    Javier de Castro, Amalio Ordóñez & Manuel González Barón

  2. Hospital Clínico Universitario de Zaragoza, Zaragoza, Spain

    Dolores Isla

  3. Hospital Provincial de Castellón, Castellon, Spain

    Alfredo Sánchez

  4. Hospital Son Llatzer, Palma de Mallorca, Spain

    Antonio Arrivi

  5. Hospital German Trias i Pujol, Barcelona, Spain

    José Luis Manzano

Authors
  1. Javier de Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amalio Ordóñez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dolores Isla
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alfredo Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonio Arrivi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. José Luis Manzano
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Manuel González Barón
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manuel González Barón.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Castro, J., Ordóñez, A., Isla, D. et al. Early intervention with epoetin beta prevents severe anaemia in patients with solid tumours receiving platinum-based chemotherapy: results of the NeoPrevent study. Cancer Chemother Pharmacol 59, 35–42 (2007). https://doi.org/10.1007/s00280-006-0251-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00280-006-0251-4

Keywords

Search

Navigation