Robert E. Smith, Jr, MD

The year 1991 was truly a watershed year in medical oncology,as three events resulted in aparadigm shift in the tolerability,safety, and symptom management ofchemotherapy delivery. The first twoevents moved chemotherapy administrationfrom a user-unfriendly hospitalinpatient environment to whatevolved into a highly efficient, sophisticated,outpatient system led by privatepractitioners of medical oncology.Ondansetron (Zofran), the first of the5HT3-receptor antagonists, providedreliable prophylaxis of immediatechemotherapy-induced nausea andvomiting in highly emetogenic regimens.[1] Recombinant human granulocytecolony-stimulating factor(rhG-CSF, filgrastim [Neupogen]),[2]if dosed appropriately, significantlyreduced the duration of severe neutropeniathrough its role as the primaryregulator of increased production andrelease of granulocytes from the bonemarrow.

Anemia is the most common hematologic abnormality seen in patients with cancer. Anemia is associated with debilitating symptoms and poorer health-related quality of life and may result in less than optimal disease/treatment outcomes.