title: Experimental and investigational therapies for chemotherapy-induced anemia.
abstract: BACKGROUND
  In cancer patients, anemia is frequently observed, particularly as a consequence to chemotherapy (chemotherapy-induced anemia, CIA). CIA is treated with Red Blood Cell transfusions and erythropoiesis-stimulating agents (ESAs). However, the use of ESAs in anemic cancer patients is associated with reduced survival time and time to progression. Consequently, new therapeutic options are needed.
  
  
  METHODS
  In this article, the authors discuss new erythroid-enhancing agents (EEAs) that act differently to erythropoietin. Specifically, the article summarizes the early clinical development of activin antagonists (Sotatercep [ACE-011] and ACE-536) and hepcidin antagonists [NOX-H94]).
  
  
  CONCLUSIONS
  Both Activin RIIA trap agents and hepcidin inhibitors are promising new EEAs, but their safety profile, and their impact on treating CIA, needs to be carefully assessed in controlled clinical trials over longer periods of time. It is also important to carefully evaluate CIA patients to properly assess the physiopathological mechanisms responsible for the development of their anemic condition and provide patients with the most appropriate treatment plan.
authors.affiliation: a Istituto Superiore di Sanità, Department of Hematology, Oncology and Molecular Medicine , Viale Regina Elena 299, Rome, Italy ugo.testa@iss.it.
authors.forename: Ugo
authors.initials: U
authors.lastname: Testa
authors.affiliation: a Istituto Superiore di Sanità, Department of Hematology, Oncology and Molecular Medicine , Viale Regina Elena 299, Rome, Italy ugo.testa@iss.it.
authors.forename: Germana
authors.initials: G
authors.lastname: Castelli
authors.affiliation: a Istituto Superiore di Sanità, Department of Hematology, Oncology and Molecular Medicine , Viale Regina Elena 299, Rome, Italy ugo.testa@iss.it.
authors.forename: Pelosi
authors.initials: P
authors.lastname: Elvira
mesh_terms: D028341:Activins / Q000037:antagonists & inhibitors; D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018450:Disease Progression; D015195:Drug Design; D015507:Drugs, Investigational / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006397:Hematinics / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D064451:Hepcidins / Q000037:antagonists & inhibitors; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D015507:Drugs, Investigational; D006397:Hematinics; D064451:Hepcidins; D028341:Activins
keywords: ACE-011; ACE-536; NOX-H94; Sotatercept; activin II receptors; anemia; cancer; hepcidin