Weekly epoetin alfa during adjuvant chemotherapy for breast cancer: Effect on hemoglobin levels and quality of life

Clifford A. Hudis, Charles L. Vogel, Julie R. Gralow, Denise Williams, Martin Abrams, Jonathan Abramson, John Adams, Kent Adler, Mahmoud Afifi, Fakhiuddin Ahmed, Harish G. Ahuja, Judith A. Albro, Mitchell Alden, Michael Alexander, Mohammed Y. Ali, Ghassan Al-Jazayrly, Anderson M. Ambinder, V. C. Amin, John Anagnost, Michael Y. AshigbiOmar T. Atiq, Mary Lou Auchus, Craig J. Badolato, Thomas Baeker, Edward Balaban, Bruce Bank, Bharat H. Barai, Luis R. Barreras, Wilbur B. Bassett, Charles L. Beall, J. Thaddeus Beck, Elliot M. Belenkov, Donna A. Bell, Dan Ben-Zeev, Michael Berkovic, Dennis Berman, Utpal K. Bhanja, Karin Bigman, Roger T. Biss, Nanda Biswas, Kenneth Blankstein, Douglas Blayney, Virginia F. Borges, Linda D. Bosserman, Cordell J. Bott, Gino C. Bottino, L. Eamonn Boyle, Ranga Brahmamdam, Elizabeth J. Brate, William Brinkley, Katheleen Briscoe, Paula Broadway, Marcia J. Browne, Patricia Burns, Gary V. Burton, Atul Butala, Patricia Byrne, Vincent Caggiano, Elber Camacho, Laura C. Campbell, Luis Campos, Salvadore Caputto, Mark Carlson, Linda Carmosino, Jean M. Carrellas, Jennifer H. Caskey, William Cathcart-Rake, Majd Chahin, Kerry E. Chamberlain, Veena Charu, Sant P. Chawla, Alice P. Chen, David Chernicoff, Gurdeep Chhabra, Bernard Chinnasami, Jennifer Choate, Janak Choksi, Anthony Ciarolla, Patrick Cobb, Everardo Cobos, Paul Coluzzi, John D. Conroy, Javier Corral, John J. Costanzi, Mark Coughenour, Greenville Creekbaum, Jennie R. Crews, Edward B. Crowell, William Cunningham, Snehal A. Damle, Sheldon Davidson, Cathy Deen, Michael DeLeo, Salvatore A. DelPrete, Michael DeMattia, Eknath Deo, Francisco H. Dexeus, Robert F. Dobrzynski, Gary Dosik

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Purpose: Anemia, fatigue, and diminished quality of life (QOL) often are associated with chemotherapy. In a previous study of patients with early-stage breast cancer and mean baseline hemoglobin (Hb) level of 12.1 g/dL, Hb decreased by 2.0 g/dL after 4 cyles of adjuvant chemotherapy. The current open-label, nonrandomized, multicenter, prospective, community-based study evaluated the effects of 12-24 weeks of epoetin alfa (40,000 U subcutaneously once weekly initiated at the start of start of standard adjuvant chemotherapy) in patients with stage I-III breast cancer and baseline Hb levels ≥ 10 g/dL to ≤ 14 g/dL on Hb level, transfusions, and QOL. Patients and methods: Of 1792 patients enrolled, 1785 were evaluable for safety and 1632 for efficacy. Mean age was 53 years ± 10.7 and mean baseline Hb level was 12.3 g/dL ± 1.0. From baseline levels, epoetin alfa significantly increased Hb (1.3 g/dL ± 1.5; P < 0.05) and improved QOL according to the Linear Analog Scale 26.7), and Functional Assessment of Cancer Therapy-Anemia (1.7 points ± 14.0; P < 0.05 in each case). Patients with baseline mild anemia (Hb level > 10 g/dL to ≤ 12 g/dL) also had significant improvements from baseline levels in all 3 LASA parameters (P < 0.05). Epoetin alfa was well tolerated, clinically relevant thrombovascular events were reported in 4.3 % of patients. Results: In this study, epoetin alfa significantly improved Hb and QOL in mildly anemic patients with early-stage breast cancer receiving adjuvant chemotherapy. However, based on recent studies showing an increased risk of thrombovascular events in patients with cancer treated with erythropoietic agents beyond correction of anemia, treatment with epoetin alfa is not indicated or recommended in patients with cancer and Hb levels > 12 g/dL. Conclusion: Controlled studies are warranted to confirm the safety and efficacy of epoetin alfa therapy in patients with mild anemia receiving chemotherapy.

Original languageEnglish (US)
Pages (from-to)132-142
Number of pages11
JournalClinical Breast Cancer
Issue number2
StatePublished - Jun 2005

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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