Document Detail

Meta-analysis of epoetin beta and darbepoetin alfa treatment for chemotherapy-induced anemia and mortality: Individual patient data from Japanese randomized, placebo-controlled trials.
MedLine Citation:
PMID:  23331490     Owner:  NLM     Status:  MEDLINE    
Erythropoiesis-stimulating agents (ESA) reduce the need for transfusions and improve the quality of life in patients receiving chemotherapy, but several clinical trials have suggested that ESA might have a negative impact on survival. To evaluate the efficacy and safety of ESA, epoetin beta and darbepoetin alfa, including their impact on overall survival and thromboembolic events, we conducted an individual data-based meta-analysis of three randomized, placebo-controlled trials studying Japanese patients with chemotherapy-induced anemia. All trials were conducted in compliance with Good Clinical Practice. A total of 511 patients with solid tumor or lymphoma (epoetin beta or darbepoetin alfa, n = 273; placebo, n = 238) were included. The ESA significantly reduced the risk of transfusion (relative risk, 0.47; 95% confidence interval, 0.29-0.76). No significant effect of the ESA on overall survival was observed (unadjusted hazard ratio, 1.00; 95% confidence interval, 0.75-1.34). A prespecified subgroup analysis showed no strong interaction between the baseline hemoglobin concentration and the effect of ESA on overall survival. Among the ESA-treated patients, the highest hemoglobin achieved during the treatment period in each patient had no impact on mortality. No increase in thromboembolic events was observed in the ESA-treated patients (0.7% vs 1.7% placebo). The ESA reduced the risk of transfusion without a negative impact on the survival of patients with chemotherapy-induced anemia.
Yasuo Ohashi; Yukari Uemura; Yasuhito Fujisaka; Toru Sugiyama; Hironobu Ohmatsu; Noriyuki Katsumata; Rumiko Okamoto; Nagahiro Saijo; Tomomitsu Hotta
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't     Date:  2013-03-15
Journal Detail:
Title:  Cancer science     Volume:  104     ISSN:  1349-7006     ISO Abbreviation:  Cancer Sci.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-25     Completed Date:  2013-05-29     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  101168776     Medline TA:  Cancer Sci     Country:  England    
Other Details:
Languages:  eng     Pagination:  481-5     Citation Subset:  IM    
Copyright Information:
© 2013 Japanese Cancer Association.
Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan.
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MeSH Terms
Anemia / chemically induced,  drug therapy*,  mortality
Antineoplastic Agents / adverse effects*
Asian Continental Ancestry Group
Erythropoietin / administration & dosage,  analogs & derivatives*
Hematinics / therapeutic use*
Randomized Controlled Trials as Topic
Recombinant Proteins / administration & dosage
Reg. No./Substance:
0/Antineoplastic Agents; 0/Hematinics; 0/Recombinant Proteins; 0/epoetin beta; 11096-26-7/Erythropoietin; 15UQ94PT4P/darbepoetin alfa

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