title: Overcoming barriers to erythropoietic therapy. Characteristics of darbepoetin alfa and potential advances in scheduling, dosing, and dose-efficiency.
abstract: Barriers to use of erythropoietic therapy in cancer patients include nonresponse in a sizable proportion, resultant lowering of cost-effectiveness, and inconvenience. Darbepoetin alfa represents the outcome of efforts to develop agents with improved erythropoietic potency. This agent has been shown to produce high dose-related response rates, reduce risk of transfusion, and produce dose-related rapidity of response in cancer patients; no loss in dose-efficiency is observed with once-every-2-week dosing compared with weekly dosing, and the feasibility of every-3-week dosing has been demonstrated. In addition, the characteristics of this agent may permit a treatment schedule consisting of front loading with an optimal dose followed by low-dose maintenance, which may further improve dose-efficiency and cost-effectiveness of treatment. The characteristics of darbepoetin alfa suggest the ability to improve overall quality of erythropoietic therapy, which may increase its utilization in patients who would benefit from such treatment.
authors.affiliation: Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA. jglaspy@mednet.ucla.edu
authors.forename: John A
authors.initials: JA
authors.lastname: Glaspy
mesh_terms: D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects; D002986:Clinical Trials as Topic; D000068256:Darbepoetin alfa; D004334:Drug Administration Schedule; D004921:Erythropoietin / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D009369:Neoplasms / Q000097:blood / Q000150:complications / Q000188:drug therapy; D011994:Recombinant Proteins
chemical_list: D000970:Antineoplastic Agents; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068256:Darbepoetin alfa