Erythropoiesis-stimulating agents: favorable safety profile when used as indicated.
OBJECTIVE
Several studies with erythropoiesis-stimulating agents (ESAs) have raised a number of safety issues. Therefore, a discussion of available data in light of the current EORTC guidelines 2006 on the use of ESAs in anemic patients is warranted.


METHODS
Literature is reviewed with respect to experimental and clinical data on the effect of ESA therapy on tumor growth both in the preclinical setting and on patient survival.


RESULTS
Studies showing an adverse effect of ESA therapy on patient survival generally exhibit considerable methodological deficiencies. Moreover, they investigated treatment situations for which ESAs are not approved and/or did not involve recommended baseline ("intervention") or target hemoglobin levels.


CONCLUSIONS
When used as indicated, ESAs are valuable and safe drugs for the treatment of anemia and do not negatively affect patient survival. In particular, the data situation confirms the importance and correctness of the EORTC guidelines 2006 and their recently updated version. It is therefore recommended that these guidelines continue to be strictly followed in the treatment of chemotherapy-induced anemia.
Nowrousian
Mohammad R
MR
Department of Internal Medicine Cancer Research, West-German Cancer Center, University Hospital Essen, Germany.
Dunst
Jürgen
J
Vaupel
Peter
P
D000328:Adult; D000740:Anemia / Q000139:chemically induced* / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001803:Blood Transfusion; D002986:Clinical Trials as Topic; D017322:Clinical Trials, Phase II as Topic; D004195:Disease Models, Animal; D018450:Disease Progression; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D051379:Mice; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality* / Q000532:radiotherapy; D009374:Neoplasms, Experimental; D010100:Oxygen / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D051381:Rats; D017467:Receptors, Erythropoietin / Q000235:genetics* / Q000627:therapeutic use; D011994:Recombinant Proteins; D012307:Risk Factors; D012449:Safety; D014407:Tumor Cells, Cultured / Q000187:drug effects
D000970:Antineoplastic Agents; D006397:Hematinics; D006454:Hemoglobins; D017467:Receptors, Erythropoietin; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D000068817:Epoetin Alfa; D010100:Oxygen