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 ne cessitating blood transfusion. This multicentre study was designed to evalu ate the efficacy and safety of epoetin a in preventing the decline in haemo globin (Hb) level, and to determine whether the transfusion requirement cou ld 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 alpha 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 alpha dosage were made during the study if Hb level i ncreased 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 or-treated patients experienced anaemia (Hb < 10 g dl(-1)) d uring the course of chemotherapy (300 IU kg(-1), 39%; 150 IU kg(-1), 48%; u ntreated, 66%). This was reflected in the significantly lower number of tre ated patients transfused [300 IU kg(-1), 20% (P < 0.001); 150 IU kg(-1), 45 % (P < 0.05); untreated, 59%]. Epoetin alpha was well-tolerated, and there was no evidence of sustained, clinically significant, hypertension. In summ ary, epoetin a is effective and well-tolerated in maintaining Hb level and reducing transfusion requirement in patients undergoing cyclic chemotherapy for SCLC.