Epoetin alpha prevents anaemia and reduces transfusion requirements in patients undergoing primarily platinum-based chemotherapy for small cell lung cancer

Anaemia commonly occurs in cancer patients receiving chemotherapy, often necessitating blood transfusion. This multicentre study was designed to evaluate the efficacy and safety of epoetin α in preventing the decline in haemoglobin (Hb) level, and to determine whether the transfusion requirement could be reduced, in patients receiving 4–6 cycles of primarily platinum-based combination cyclic chemotherapy for small cell lung cancer (SCLC). A total of 130 non-anaemic SCLC patients were randomized to receive no additional treatment (n = 44), epoetin α 150 IU kg–1 subcutaneously (s.c.) three times a week (n = 42) or 300 IU kg–1 s.c. three times a week (n = 44). Reductions in epoetin α dosage were made during the study if Hb level increased to >15 g dl–1. The mean weekly dosage was 335 and 612 IU kg–1, respectively, in the two active treatment groups. Significantly fewer (P < 0.05) epoetin α-treated patients experienced anaemia (Hb < 10 g dl–1) during the course of chemotherapy (300 IU kg–1, 39%; 150 IU kg–1, 48%; untreated, 66%). This was reflected in the significantly lower number of treated patients transfused [300 IU kg–1, 20% (P < 0.001); 150 IU kg–1, 45% (P < 0.05); untreated, 59%]. Epoetin α was well-tolerated, and there was no evidence of sustained, clinically significant, hypertension. In summary, epoetin α is effective and well-tolerated in maintaining Hb level and reducing transfusion requirement in patients undergoing cyclic chemotherapy for SCLC.