Adherence to new international guidelines on the use of erythropoiesis stimulating agents (ESAs) in the management of chemotherapy-induced anaemia (CIA) can improve the quality of life of cancer patients, while minimising the risks of ESA side effects.
Speakers at the Hospira-sponsored symposium at the Joint ECCO 15/34th ESMO Congress in Berlin, Germany, urged colleagues to stick to the revised haemoglobin thresholds recommended in the guidelines and target ESA treatment at those cancer patients undergoing chemotherapy who have been shown to gain most benefit.
“International guidelines now recommend initiating ESA treatment in patients with haemoglobin levels less than 10g/dL and to stop once they have become transfusion independent or when their haemoglobin levels reach 12 g/dL. If oncologists follow these recommendations in whichever country they practise, I am confident that we will see lower levels of the venous thromboembolic events reported with ESAs in earlier trials,” explained Dr Jim Janinis, Director of the Department of Medical Oncology, Athens Medical Center, Athens, Greece.
Dr Janinis presented data from three meta-analyses of ESA studies, which linked increased rates of venous thromboembolic events (VTEs) with reduced survival.
However he commented that “In many of the trials evaluated, ESA treatment had been initiated at relatively high baseline haemoglobin levels of 11-12 g/dL and continued until patients achieved target levels of 14-15 g/dL. More controlled use of ESAs, in line with the new international guidelines, would have beneficial effects on mortality as well as VTE risk.”
Two thirds of delegates using biosimilar ESA
Sixty eight per cent of delegates attending the symposium reported that their clinics were now using biosimilar ESA, according to results of interactive questions posed by Professor Stefan Frühauf, from the Department of Hematology/Oncology at the Center for Tumor Diagnostics and Therapy, Osnabrück, Germany.
During a case study discussion of optimal ESA use in clinical practice, Professor Frühauf explained that appropriate CIA management was an important part of supportive care, which could significantly impact on patients’ quality of life. He commented that his clinical experience has shown the biosimilar ESA, epoetin zeta (Retacrit), to be effective and well tolerated by patients.
Latest clinical trial data on epoetin zeta, presented at the symposium, confirmed its tolerability and efficacy in the management of CIA, adding to existing data demonstrating comparable biological activity, dose and haemoglobin response.
“The use of biosimilars, such as Retacrit, is increasing, and offers greater access to treatment. Switching to epoetin zeta presents no problem to the oncologist or the patient, and the efficacy and tolerability of treatment is well maintained,” concluded symposium chairman, Dr Paris Kosmidis, from Hygeia Hospital, Athens, Greece.