Standards of care for anemia management in oncology

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Abstract
BACKGROUND: Anemia is common in patients with lung carcinoma, particularly among those undergoing platinum‐based cytotoxic chemotherapy. Evidence is growing that anemia can have a profound impact on the patient's quality of life, often manifested as the patient's inability to function normally.METHODS: A literature review was conducted to provide a current picture of the incidence and impact of anemia in patients with lung carcinoma and the usage and limitations of current treatment.RESULTS: The incidence of anemia (a hemoglobin [Hb] level < 11g/dL) in lung carcinoma patients is approximately 50–60%, varying according to treatment regimen. However, despite evidence supporting the treatment of anemia, many clinicians only intervene when Hb levels fall below 8 g/dL. This may be because of a lack of awareness of the incidence and impact of anemia on cancer patients, but most likely is because of limitations of current treatment options (blood transfusion and recombinant human erythropoietin [epoetin‐α]). Darbepoetin‐α represents a new generation of erythropoiesis‐stimulating proteins. Biochemically distinct from epoetin‐α, darbepoetin‐α has a greater sialic acid content and biologic half‐life than epoetin‐α, but stimulates erythropoiesis in the same manner. Clinical trials involving patients with cancer‐related anemia have shown that darbepoetin‐α has a threefold longer half‐life than epoetin‐α, which may allow less frequent dosing. The results from an ongoing clinical trial dedicated to testing the clinical benefits of darbepoetin‐α in treating anemia in lung carcinoma patients will provide a valuable insight into its full potential in this setting.CONCLUSIONS: Anemia is common but is reported to be undertreated in patients with lung carcinoma. The introduction of darbepoetin‐α into clinical practice may overcome some of the limitations of current treatments and facilitate improvement in the management of cancer‐related anemia. Cancer 2002;95:613–23. © 2002 American Cancer Society.DOI 10.1002/cncr.10712

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