Epoetin Alfa Raises Quality of Life for Lung Cancer Patients

SAN FRANCISCO—Weekly doses of recombinant human erythropoietin (epoetin alfa [Procrit, Eprex, Erypo]) improved quality of life as well as hemoglobin levels for 154 lung cancer patients in a 16-week, nonrandomized pilot study. Self-assessments from patients at baseline, 8, and 16 weeks showed that their energy rose by 30% above baseline, activity by 30.6%, and overall quality of life by 22%.

As a result of the outcomes, investigators are recruiting 300 patients for a multicenter randomized trial, according to Chandra P. Belani, MD, professor of medicine at the University of Pittsburgh School of Medicine. The study demonstrated that weekly doses of epoetin alfa were safe and confirmed the results of other studies that have shown quality of life benefits in addition to increase in hemoglobin levels when epoetin is used in patients receiving chemotherapy, Dr. Belani reported.

"While patients are getting chemotherapy, most patients have anemia. We need to be proactive in treating it. We need to maintain hemoglobin levels at or above 11 to 13 g/dL to get maximum quality of life and not wait until it goes down and they complain of fatigue," Dr. Belani said.

Also Received Chemotherapy and Radiation Therapy

Investigators at the Beth Israel Medical Center/St. Luke’s-Roosevelt Hospital in New York City and Ortho Biotech Products, LP, in Raritan, New Jersey, also participated in the pilot study. "This trial fairly clearly and significantly demonstrates a quality-of-life benefit from once weekly epoetin alfa," commented Daniel P. Shasha, MD, of Beth Israel Medical Center in New York City, noting that the benefit correlated with the degree of correction of anemia. "All patients benefited, and the benefit was the most in the patients who were the most anemic." The investigators did not look at the long-term effects of epoetin alfa on local control and survival, but plan to do so in the randomized trial, Dr. Belani said.

All patients in the pilot study received chemotherapy and radiation therapy concomitantly or sequentially. The cohort was 52% male and 48% female with a mean age of 64.5 years. The mean total dose of radiation to the primary site was 5,712cGy (range: 3,000 to 7,600 cGy). Initially, all patients received 40,000 IU of epoetin alfa if their hemoglobin levels fell to or below 11 g/dL. Dr. Belani noted that it was well tolerated.