Twist and Shout: One Decade of Meta-Analyses of Erythropoiesis-Stimulating Agents in Cancer Patients
2010; Karger Publishers; Volume: 125; Issue: 1-2 Linguagem: Inglês
10.1159/000318897
ISSN1421-9662
AutoresJulia Bohlius, Thomy Tonia, Guido Schwarzer,
Tópico(s)Erythrocyte Function and Pathophysiology
ResumoAnemia associated with cancer and cancer therapy is a common and important issue in the treatment of patients with malignant disease. Conventionally, blood transfusions are used to treat severe cancer-related anemia. Short- and long-acting preparations of recombinant human erythropoiesis-stimulating agents (ESAs) offer an alternative treatment option. Multiple studies and subsequent meta-analyses have demonstrated that ESA treatment increases hemoglobin levels and reduces the likelihood of transfusion for a proportion of treated patients. However, studies that attempted to evaluate whether ESAs improve tumor response and survival have generated conflicting evidence. Results of smaller trials reporting improved survival outcomes were contradicted by large randomized controlled trials that reported more deaths in patients receiving ESAs. In addition, there is strong evidence that cancer patients receiving ESAs have an increased risk of thromboembolic and cardiovascular events. We herein review the main meta-analyses published in the field, their strengths and weaknesses, their contribution to patient management and future perspectives for systematic reviews.
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