title: Evaluating the effectiveness of epoetin alfa in community oncology practices.
abstract: OBJECTIVE
  This retrospective case-series review studied the effectiveness of epoetin alfa in community oncology practices, which until now has not been well documented.
  
  
  METHODS
  We reviewed the medical records of 118 cancer patients treated between 1999 and 2001 with cyclic chemotherapy plus epoetin alfa in 27 US community-based oncology practices. Two analysis sets were examined: one including all patients (n=118) and one including only those patients with no concurrent events impacting hemoglobin data interpretation (n=73). Efficacy of epoetin alfa was evaluated by hemoglobin response (aS2 g/dl increase in hemoglobin from baseline) at weeks 12 and 16, the time to hemoglobin response, and change in hemoglobin concentrations from baseline at specific time points.
  
  
  RESULTS
  After 12 weeks of treatment, 43% (95% confidence interval [CI], 33-54%) of patients had a hemoglobin response, and the proportion of responders further rose to 61% (95% CI, 49-72%) after 16 weeks. The median time to response was 92 days (lower 95% confidence limit, 74 days; upper bound not estimable). Hemoglobin increased from baseline at all time points evaluated during epoetin alfa treatment, with a mean increase of 1.1 g/dl (95% CI, 0.77-1.4 g/dl) by the last observation.
  
  
  CONCLUSIONS
  These results indicate that epoetin alfa is effective in community practice, but most patients take longer than 3 months to respond. Because slow responses may negatively impact on the quality of life in these patients, alternative treatment approaches providing faster and perhaps better responses may provide greater clinical benefit.
authors.affiliation: Hematology Oncology Consultants Inc., Ravines Edge Court, Columbus, OH 43235, USA. hspiridoni@aol.com
authors.forename: C
authors.initials: C
authors.lastname: Harris Spiridonidis
authors.forename: K
authors.initials: K
authors.lastname: Brinkmannb
authors.forename: M
authors.initials: M
authors.lastname: Fridman
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.forename: R E
authors.initials: RE
authors.lastname: Tannous
mesh_terms: D000368:Aged; D003153:Community Health Services; D004341:Drug Evaluation; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa