Response predicting factors to recombinant human erythropoietin in cancer patients undergoing platinum‐based chemotherapy

Response predicting factors to recombinant human erythropoietin in cancer patients undergoing platinum‐based chemotherapy

BACKGROUND The response to epoetin‐α treatment is hard to predict in cancer patients receiving chemotherapy. METHODS One hundred and seventeen patients were enrolled in this observational study. They had a hemoglobin (Hb) level less than or equal to 10.5 g/dL, were receiving platinum chemotherapy wi...

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Bibliographic Details
Published in:Cancer Vol. 95; no. 11; pp. 2408 - 2413
Main Authors: González‐Barón, Manolo, Ordóñez, Amdio, Franquesa, Rosa, Constenla, Manuel, Montalar, Joaquin, Gili, Frederic, Camps, Carlos, Sancho, José Felix, Pérez‐Cachot, Pedro
Format: Journal Article Conference Proceeding
Language:English
Published: New York Wiley Subscription Services, Inc., A Wiley Company 01-12-2002
Wiley-Liss
Subjects:
Adult
Aged
Anemia - chemically induced
Anemia - drug therapy
Antineoplastic agents
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biological and medical sciences
Chemotherapy
Cisplatin - adverse effects
Cisplatin - therapeutic use
Epoetin Alfa
epoetin‐α
Erythropoietin - administration & dosage
Erythropoietin - pharmacology
Female
Hematinics - administration & dosage
Hematinics - pharmacology
hemoglobin level
Hemoglobins - analysis
Humans
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
platinum chemotherapy
Predictive Value of Tests
Prognosis
Recombinant Proteins
response rate
Treatment Outcome
Antineoplastic agent
Human
Platinum Complexes
Erythropoietin
Anemia
Treatment efficiency
Hemoglobinemia
response rate
epoetin-a
Hemopathy
Malignant tumor
Glycoprotein hormone
platinum chemotherapy
Chemotherapy
Treatment
hemoglobin level
Complication
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Summary:BACKGROUND The response to epoetin‐α treatment is hard to predict in cancer patients receiving chemotherapy. METHODS One hundred and seventeen patients were enrolled in this observational study. They had a hemoglobin (Hb) level less than or equal to 10.5 g/dL, were receiving platinum chemotherapy with three cycles pending, and they did not have an iron deficiency or hemolysis. Epoetin‐α was administered subcutaneously three times a week at a dose of 150 IU/kg. Ninety patients were examined. RESULTS Response was defined as an increase in Hb of at least 2 g/dL during the treatment period. The response rate was 63.3%. The following data were compared between responders and nonresponders at the onset of treatment and after 2 and 4 weeks of epoetin therapy: Hb, reticulocytes, serum iron, ferritin, transferrin, transferrin saturation index, and endogenous erythropoietin levels. At baseline, these variables were similar for responders and nonresponders; after 2 weeks, responders showed higher Hb (P = 0.001) and transferrin levels (P = 0.042) and reticulocyte counts (P = 0.003); after 4 weeks, only the Hb level showed a significant difference (P < 0.0005). Changes from baseline in Hb level after 2 and 4 weeks correlated significantly (P < 0.01) with response. The change in Hb level at Week 4 was the best predictor. A change in Hb level of less than 0.5 g/dL was associated with a lack of response (predictive power, 71%); a change in Hb greater than or equal to 0.5 g/dL was associated with response (predictive power, 89%). CONCLUSIONS Response to epoetin‐α treatment in cancer patients receiving platinum chemotherapy can be predicted from changes in Hb level after 4 weeks of therapy. Cancer 2002;95:2408–13. © 2002 American Cancer Society. DOI 10.1002/cncr.10980 The change in hemoglobin (Hb) values after 4 weeks of treatment proved to be the prognostic factor that best explained the response to human recombinant erythropoietin in cancer patients receiving platinum chemotherapy. The response algorithm can be summarized as follows: the power to predict response to treatment (when the rise in Hb ≥ 0.5 g/dL) is 89.1% and the power to predict nonresponse (when the rise in Hb is < 0.5 g/dL) is 71%.
Bibliography:Fax: 011‐34917277118
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.10980