(February 26, 2008 - Insidermedicine) Use of erythropoiesis-stimulating agents (ESAs) to treat anemia places cancer patients at increased risk for venous thromboemolism (VTE) and death, according to research published in the Journal of the American Medical Association.

Here are some recommendations regarding the use of erythropoietin in cancer patients with non-hematologic malignancies receiving chemotherapy from Cancer Care Ontario:

•    It is recommended as a safe and effective treatment option if given with the intent of reducing the incidence of symptomatic treatment-related anemia and the need for red blood cell transfusion.

•    It is recommended as a reasonable treatment option in patients in whom a slow decline in hemoglobin is associated with increased fatigue and perceived reductions in quality of life.

•    It is not recommended in situations where rapid (i.e., less than 4 weeks) recovery of hemoglobin is required.

Researchers out of the Northwestern University Feinberg School of Medicine conducted a meta-analysis of phase 3 clinical trials that compared the use of ESAs to treat anemia in patients with cancer with placebo in order to determine the rate of VTE and mortality associated with this therapy. Overall, they used data from 51 phase 3 clinical trials involving over 13,000 cancer patients to assess mortality rate and 38 trials involving over 8,000 patients to assess VTE rate.

Use of ESAs was found to increase the risk of VTE by 57%. Mortality rates were also significantly higher in patients treated with ESAs, compared with those given a placebo.

Today's research demonstrates that ESAs – drugs that are commonly prescribed as part of supportive care for patients with cancer – may pose significant safety risks when used in this manner.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.