The development of erythropoietic agents in oncology

Glaspy, John A.

doi:10.1517/14728214.10.3.553

Cited by 17 publications

(4 citation statements)

References 69 publications

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“…The authors of meta‐analyses and systematic reviews [158,312‐318] suggest that patients receiving recombinant erythropoiesis‐stimulating agents (ESAs) to correct anemia measured at less than 10 g/dL may experience increased vigor and diminished fatigue. However, there is only limited evidence that ESAs improve fatigue when anemia is less severe, and the use of these agents must be considered in light of emerging safety issues, including an increased risk of thrombotic events, hypertension, and pure red cell aplasia, and concerns that ESAs may decrease locoregional disease control and survival outcomes in particular tumor types [318‐323]. Current national clinical practice guidelines [324] concluded that ESAs are not indicated for the treatment of CRF and restrict the use of ESAs for the treatment of anemia specifically related to myelosuppressive chemotherapy without curative intent.…”

Section: Interventions For Crfmentioning

confidence: 99%

Cancer‐Related Fatigue: State of the Science

Mitchell

2010

PM&R

157

145

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Cancer-related fatigue (CRF) is a disabling and distressing symptom that is highly prevalent across the cancer continuum from a patient's diagnosis and treatment through survivorship and end of life. It has a multifactorial etiology and significant individual variability in its clinical expression, determinants, and sequelae. Despite the significance of CRF, it is often underdiagnosed, and management is frequently suboptimal. This review synthesizes the state of the science concerning the features, possible mechanisms, and predictors of CRF; offers recommendations for the evaluation of CRF; and appraises the strength of the evidence for a wide range of pharmacologic and nonpharmacologic interventions to prevent and manage fatigue during and after cancer and its treatment. There is evidence from methodologically rigorous controlled trials that exercise, psycho-educational interventions, and cognitive-behavioral therapy for insomnia are effective in the treatment of CRF, and a wide range of pharmacologic and nonpharmacologic interventions has shown initial promise in single-arm pilot studies with small, heterogeneous samples. Rigorously designed and adequately powered randomized trials are warranted to (1) determine the effectiveness of promising approaches and (2) identify the interventions that are most effective in treating CRF in specific subpopulations (eg, stem cell transplant recipients, older adults, patients with lung or colorectal cancers, survivors, and those at the end of life). Studies to elucidate the biologic expression profiles of CRF, to explicate the mechanisms through which particular interventions impact CRF, and to identify the mediators and moderators of fatigue outcomes will ultimately permit individually tailored approaches for the treatment of CRF.

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Section: Interventions For Crfmentioning

confidence: 99%

Cancer‐Related Fatigue: State of the Science

Mitchell

2010

PM&R

157

145

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“…30 Studies conducted on rHuEPO have shown that it improves patients' Hb levels and quality of life and decreases transfusion requirements. 33,34 It has been proposed that ESAs also improve the cognitive function of patients receiving chemotherapy. 35 A systemic review conducted by the American Cancer Society showed that optimal clinical benefit from erythropoietic treatment of chemotherapyinduced anemia may be achieved through early intervention.…”

Section: Treatmentmentioning

confidence: 99%

Management of Anemia in Cancer Patients

Hoque¹,

Karim

Hoque

et al. 2020

Anwer Khan Mod Med Coll J

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Anemia is a frequent complication in cancer patients. Cancer-related anemia adversely affects quality of life and is associated with reduced overall survival. Reasons for anemia in cancer patients are decreased production of RBCs resulting from nutritional deficiencies; insufficient production of RBCs because of the presence of chronic disease; Cancer promotes inflammatory cytokine production, which suppresses erythropoiesis and erythropoietin (EPO) production; bone marrow infiltration by the tumor or bone marrow suppression resulting from anticancer treatment such as surgery, chemotherapy, or radiotherapy; and increased loss of RBCs caused by blood loss from the tumor, surgery, or hemolysis. Correction of anemia can be achieved by different methods.Treatment is aimed at increasing the oxygen-carrying capacity of the blood, reducing fatigue, and improving the patient's overall quality of life. Erythropoiesisstimulating agents, iron supplementation, and red blood cell transfusions have all been recommended in different settings. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 66-72

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“…In a recent review by Glaspy, it was suggested that oncologists employ three times the amount of ESAs to gain 50-60 % of the benefit in transfusion reduction achieved by nephrologists treating dialysis-associated anemia. 61 This difference may be due to the almost universal use of iron supplementation for nephrology patients taking ESAs.…”

Section: Future Directionsmentioning

confidence: 99%

Iron Deficiency Anemia in Cancer Patients

Janis¹

2012

Oncology &Amp; Hematology Review (US)

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Anemia is defined by the World Health Organization as a hemoglobin (Hb) level <13 g/dl for men and <12 g/dl for women, 1 and can be further subcategorized into mild (>10 g/dl), moderate (8-10 g/dl), severe (6.5-8 g/dl), and life-threatening (<6.5 g/dl) ranges. Anemia is a common comorbidity in cancer patients. In the previously mentioned ECAS study, cancer-related anemia was most frequently reported in patients with gynecological cancer (81.4 %), lung cancer (77 %), and lymphoma/myeloma (72.9 %). 2 In addition, this study indicated that the longer patients received chemotherapy, the higher their risk of becoming anemic. Anemia is also a recognized complication of myelosuppressive chemotherapy in cancer patients. AbstractAnemia is highly prevalent, affecting approximately 40 % of cancer patients, and results in a significant decrease in health-related quality of life while also being associated with shorter cancer survival times. A recent survey of 15,000 cancer patients in Europe found that 39 % were anemic at the time of enrolment. In addition, anemia is a recognized complication of myelosuppressive chemotherapy, and it has been estimated that, in the US, around 1.3 million cancer patients who are not anemic at the time of diagnosis will develop anemia during the course of their disease. The etiology of anemia in cancer patients is variable and often multifactorial, and may be the result of an absolute or a functional iron deficiency. Cancer produces an enhanced inflammatory state within the body-causing hepcidin levels to increase and erythropoietin production to decrease-and results in a reduction in erythropoiesis due to impaired iron transport. This type of anemia is known as functional iron deficiency, where the body has adequate iron stores but there are problems with mobilization and transport of the iron. Absolute iron deficiency is when both iron stores and iron transport are low. The National Comprehensive Cancer Network (NCCN) treatment guidelines for cancer-related anemia recommend intravenous (IV) iron products alone for iron repletion in cancer patients with absolute iron deficiency, and erythropoiesis-stimulating agents (ESAs) in combination with IV iron in cancer patients (currently undergoing palliative chemotherapy) with functional iron deficiency. Although IV iron has been demonstrated to enhance the hematopoietic response to ESA therapy, the use of supplemental iron has not yet been optimized in oncology. Here we discuss the significance of iron deficiency anemia in cancer patients and the need to implement tools to properly diagnose this condition, and we provide an overview of the management strategies and recommendations for patients with iron deficiency anemia as outlined in the NCCN guidelines.

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The development of erythropoietic agents in oncology

Cited by 17 publications

References 69 publications

Cancer‐Related Fatigue: State of the Science

Cancer‐Related Fatigue: State of the Science

Management of Anemia in Cancer Patients

Iron Deficiency Anemia in Cancer Patients

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