Impact of therapy with epoetin alfa on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. Procrit Study Group.

1997 ◽  
Vol 15 (3) ◽  
pp. 1218-1234 ◽  
Author(s):  
J Glaspy ◽  
R Bukowski ◽  
D Steinberg ◽  
C Taylor ◽  
S Tchekmedyian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Status ◽  
Cancer Patients ◽  
Hemoglobin Level ◽  
Activity Level ◽  
Epoetin Alfa ◽  
Open Label ◽  
Transfusion Requirements ◽  
The Impact

PURPOSE To study the impact of Procrit (epoetin alfa; Amgen Inc, Thousand Oaks, CA) on quality of life, transfusion requirements, and hemoglobin in anemic cancer patients receiving chemotherapy. PATIENTS AND METHODS More than 500 community-based oncologists enrolled 2,342 patients with malignancies undergoing cytotoxic chemotherapy in an open-label study. Patients were treated with epoetin alfa 150 U/kg three times weekly, which could be doubled if the therapuetic response was judged inadequate. Total treatment was up to 4 months. RESULTS Of the 2,342 patients enrolled, data were available for 2,030 patients. Of the 2,030, 1,047 patients completed all 4 months of epoetin alfa therapy. Epoetin alfa was associated with significant increases in mean self-rated scores for energy level, activity level, and overall quality of life; these improvements correlated with the magnitude of the hemoglobin increase and were independent of tumor response. In addition, epoetin alfa was associated with a significant increase in mean hemoglobin and with a significant decrease in the proportion of patients requiring transfusions (baseline to final value, P < .001). Epoetin alfa was well tolerated. CONCLUSION Epoetin alfa is effective in improving the functional status and quality of life in anemic cancer patients receiving chemotherapy, as well as increasing hemoglobin level and decreasing transfusion requirements. Improvement in functional status can be attributed to an increase in hemoglobin level, demonstrating that quality of life in this group of patients can be improved by aggressively treating anemia. Further studies will be required to define the optimal doses and schedules for epoetin alfa.

Cachexia in treatment-naïve gynecological cancer patients: Prevalence, predictors, and clinical associations.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17576-e17576
Author(s):  
Niamh O'Donoghue ◽  
Charlie Sullivan ◽  
Claire Thompson ◽  
Feras Abu Saadeh ◽  
Waseem Kamran ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Length Of Stay ◽  
Functional Status ◽  
Cancer Patients ◽  
Gynaecological Cancer ◽  
Composition Analysis ◽  
Gynaecological Malignancy ◽  
The Impact

e17576 Background: Cancer cachexia is associated with considerable morbidity and mortality, yet its prevalence in gynaecological malignancy is unknown. Prevalence of cachexia in de novo gynaecological cancer patients and the impact of cachexia on clinical parameters and patient-reported outcomes were investigated. Methods: A prospective, exploratory study of newly diagnosed gynaecological cancer patients was conducted at St. James’s Hospital, the largest treatment provider for gynaecological malignancy in the Republic of Ireland. Patients recently diagnosed with a gynaecological cancer were eligible. Demographics, oncological history, Clavien Dindo Classification and length of stay were collected from participants’ medical record. A questionnaire completed by participants on 3 consecutive days collected data on height, weight, weight history, recent dietary intake, nutritional impact symptoms and functional status. Cachexia was defined using the criteria established in 2011 (Fearon and Strasser et al, 2011). Participants’ staging computed tomography scans were utilised for body composition analysis. Descriptive statistics, Mann Whitney U tests and Chi-square were used to summarise and identify significant associations between variables. Logistic regression was used to model predictors of cachexia. The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire in conjunction with EORTC gynaecological cancer-specific modules assessed quality of life. Results: A total of 94 participants were recruited. All five gynaecological cancers were represented. Prevalence of cachexia was 21.4% and was highest in patients with cervical cancer. Any weight loss in the previous month was predictive of developing cachexia. Low albumin and anorexia were associated with cachexia, although neither reached significance. Median post-operative length of stay for cachectic patients was 5 days (range 1-57) compared to 4 days (range 0-27) for non-cachectic patients (p = 0.682). 60% of cachectic patients had some post-operative complication. Cachectic patients were more symptomatic and had lower functional status in all quality of life categories, with the exception of emotional function. Conclusions: As prevalence of cachexia in this population is at least 22%, we strongly recommend screening for cachexia at all clinical assessments. Although weight loss and body mass index can identify the majority of cachectic patients, skeletal muscle mass index should also be included where possible. Its incorporation into standard radiology assessment of cancer patients would be optimal. Further research is warranted in a larger population to fully elucidate the predictors of cachexia. Quality of life is a useful means to monitor symptoms and functional status which may contribute to or exacerbate cachexia.

SUN-PO083: Nutritional Status, Functional Status and Quality of Life – What is the Impact on Cancer Patients?

2019 ◽  
Vol 38 ◽  
pp. S89-S90
Author(s):  
C.A. Santos ◽  
I. Santos ◽  
L. Mendes ◽  
C. Ferreira ◽  
H. Mansinho
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Functional Status ◽  
Cancer Patients ◽  
The Impact

The impact of weekly dosing of epoetin alfa on the haematological parameters and on the quality of life of anaemic cancer patients

2005 ◽  
Vol 14 (2) ◽  
pp. 108-112 ◽  
Author(s):  
P. HERAS ◽  
A.A. ARGYRIOU ◽  
S. PAPAPETROPOULOS ◽  
S. KARAGIANNIS ◽  
K. ARGYRIOU ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Haematological Parameters ◽  
Epoetin Alfa ◽  
The Impact

Epoetin Alfa Therapy Increases Hemoglobin Levels and Improves Quality of Life in Patients With Cancer-Related Anemia Who Are Not Receiving Chemotherapy and Patients With Anemia Who Are Receiving Chemotherapy

2001 ◽  
Vol 19 (21) ◽  
pp. 4126-4134 ◽  
Author(s):  
I. Quirt ◽  
C. Robeson ◽  
C. Y. Lau ◽  
M. Kovacs ◽  
S. Burdette-Radoux ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Eastern Cooperative Oncology Group ◽  
Epoetin Alfa ◽  
Open Label ◽  
Open Label Study ◽  
Patients With Cancer ◽  
Cancer Related Anemia ◽  
Linear Analog Scale Assessment

PURPOSE: To evaluate efficacy, safety, and quality of life (QOL) changes with epoetin alfa therapy for anemia in patients with nonmyeloid malignancies.PATIENTS AND METHODS: Anemic cancer patients were enrolled onto this prospective, open-label study from 34 centers across Canada. The trial had two cohorts: patients who were and were not receiving chemotherapy during the 16-week study. All patients initially received epoetin alfa 150 IU/kg subcutaneously three times per week. The dose was doubled after 4 weeks for patients who did not experience sufficient response.RESULTS: Of the 183 patients enrolled in the nonchemotherapy cohort, statistically significant and clinically relevant improvements in QOL were observed with epoetin alfa therapy using both the FACT-An questionnaire and linear analog scale assessment. Hemoglobin levels increased significantly (P < .001; mean increase 2.5 g/dL from baseline to end of study) and these increases were positively correlated with improved QOL and change in Eastern Cooperative Oncology Group (ECOG) scores. There was a significant reduction in the percentage of patients who required blood transfusions. The 218 patients in the chemotherapy cohort also experienced significant improvements in QOL, decreased transfusion use, and increased hemoglobin levels that correlated with QOL improvements and change in ECOG scores. Epoetin alfa was well-tolerated in both cohorts.CONCLUSION: Epoetin alfa administered to patients with cancer-related anemia for up to 16 weeks resulted in significantly improved QOL, increased hemoglobin levels, and decreased transfusion use. These benefits were observed in cancer patients who were not receiving chemotherapy as well as those who were.

Benefits Associated with an Early Hemoglobin Response to Epoetin Alfa Therapy in the Treatment of Chemotherapy-Related Anemia

2005 ◽  
Vol 3 (6) ◽  
pp. 807-816 ◽  
Author(s):  
Susana M. Campos ◽  
Mei Sheng Duh ◽  
Patrick Lefebvre ◽  
James Rosberg
Keyword(s):  
Quality Of Life ◽  
Drug Utilization ◽  
Ad Hoc ◽  
Early Response ◽  
Community Studies ◽  
Epoetin Alfa ◽  
Open Label ◽  
Transfusion Requirements ◽  
Clinical Benefits

Although previous studies have recognized that timely correction of anemia is desirable, no published research quantifies the association between the timeliness of the hemoglobin rise and patients' outcomes. This study evaluates whether anemic patients with cancer who are receiving chemotherapy and who experienced an early response to epoetin alfa (≥ 1 g/dL hemoglobin increase at the end of 4 weeks of treatment) experienced better clinical and drug utilization outcomes compared with patients who did not experience an early response. Three large, open-label, community studies of epoetin alfa for the treatment of chemotherapy-related anemia were retrospectively analyzed to assess the association of early hemoglobin response to subsequent transfusion requirements, subsequent hemoglobin response, quality of life, and epoetin alfa dosage administered over the study. Two epoetin alfa dosing regimens were evaluated: 10,000 units 3 times weekly with potential escalation to 20,000 units, and 40,000 units once weekly with potential escalation to 60,000 units. In all studies, patients who experienced an early hemoglobin response had statistically lower subsequent transfusion requirements, higher rates of subsequent hemoglobin response, shorter time to hemoglobin response, better improvements in quality of life scores, and lower average weekly epoetin alfa dose than patients who did not experience an early hemoglobin response. Similar proportions of patients experienced early response in the 3-times weekly and once-weekly epoetin alfa regimens. This ad hoc analysis found that early hemoglobin response to epoetin alfa therapy was associated with improved clinical benefits and drug utilization. Early hemoglobin response may therefore be considered as a desired goal of epoetin alfa therapies.

scholarly journals Relationship between changes in hemoglobin level and quality of life during chemotherapy in anemic cancer patients receiving epoetin alfa therapy

Cancer ◽  
2002 ◽  
Vol 95 (4) ◽  
pp. 888-895 ◽  
Author(s):  
Jeffrey Crawford ◽  
David Cella ◽  
Charles S. Cleeland ◽  
Pierre-Yves Cremieux ◽  
George D. Demetri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Hemoglobin Level ◽  
Epoetin Alfa

Weekly Epoetin Alfa Maintains Hemoglobin, Improves Quality of Life, and Reduces Transfusion in Breast Cancer Patients Receiving Chemotherapy

2005 ◽  
Vol 23 (12) ◽  
pp. 2597-2605 ◽  
Author(s):  
Jose Chang ◽  
Felix Couture ◽  
Scott Young ◽  
Kara-Lee McWatters ◽  
Catherine Y. Lau
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Group Versus ◽  
Standard Of Care ◽  
Epoetin Alfa ◽  
Dose Increase ◽  
Breast Cancer Patients ◽  
Transfusion Requirements

Purpose Epoetin alfa administered at 40,000 U once weekly (qw) to anemic cancer patients receiving chemotherapy increases hemoglobin levels, improves quality of life (QOL), and reduces transfusions. The benefit of epoetin alfa in maintaining hemoglobin levels in cancer patients with hemoglobin less than 12 g/dL has not been evaluated. Methods Breast cancer patients (N = 354) receiving chemotherapy were randomly assigned in 1:1 ratio to epoetin alfa (40,000 U qw) or standard of care (SOC). QOL was assessed at baseline and week 12. Hemoglobin responses, transfusion requirements, and prognostic factors for responses were measured. Results At week 12, Functional Assessment of Cancer Therapy–Anemia (FACT–An; mean, 2.16 ± 12.84 for epoetin alfa v −4.43 ± 13.42 for SOC) and FACT–An fatigue (mean, 1.85 ± 10.52 for epoetin alfa v −3.55 ± 11.14 for SOC) change scores were significantly higher in the epoetin alfa group (P < .0001). Hemoglobin responses defined as mean hemoglobin ≥ 12 g/dL or a ≥ 2 g/dL increase compared with baseline were significantly higher in the epoetin alfa group versus SOC: 52.0% v 5.1% and 65.7% v 6.3%, respectively (P < .0001 for both comparisons). Percentage transfused was significantly lower in the epoetin alfa group compared with SOC (8.6% v 22.9%). More than 90% of patients did not require a dose increase and 28.7% had a dose reduction. Conclusion Epoetin alfa administered at 40,000 U qw is effective in improving QOL, maintaining hemoglobin level, and reducing transfusion requirements in breast cancer patients. The high effectiveness observed could be attributed in part to early treatment with epoetin alfa.

Clinical Evaluation of Once-Weekly Dosing of Epoetin Alfa in Chemotherapy Patients: Improvements in Hemoglobin and Quality of Life Are Similar to Three-Times-Weekly Dosing

2001 ◽  
Vol 19 (11) ◽  
pp. 2875-2882 ◽  
Author(s):  
Janice L. Gabrilove ◽  
Charles S. Cleeland ◽  
Robert B. Livingston ◽  
Brenda Sarokhan ◽  
Eric Winer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Underlying Disease ◽  
Epoetin Alfa ◽  
Concomitant Chemotherapy ◽  
Open Label ◽  
Community Based ◽  
Transfusion Requirements ◽  
Clinical Benefits ◽  
Chemotherapy Patients

PURPOSE: To prospectively evaluate the effectiveness, safety, and clinical benefits of once-weekly epoetin alfa therapy as an adjunct to chemotherapy in anemic cancer patients. PATIENTS AND METHODS: A total of 3,012 patients with nonmyeloid malignancies who received chemotherapy were enrolled onto this multicenter, open-label, nonrandomized study conducted in 600 United States community-based practices. Patients received epoetin alfa 40,000 U once weekly, which could be increased to 60,000 U once weekly after 4 weeks dependent on hemoglobin response. Treatment was continued for a maximum of 16 weeks. RESULTS: Among the 2,964 patients assessable for efficacy, epoetin alfa therapy resulted in significant increases in hemoglobin levels, decreases in transfusion requirements, and improvements in functional status and fatigue as assessed by the linear analog scale assessment (energy level, ability to perform daily activities, and overall quality of life) and the anemia subscale of the Functional Assessment of Cancer Therapy–Anemia questionnaire. Improvements in quality-of-life parameters correlated significantly (P < .001) with increased hemoglobin levels. The direct relationship between hemoglobin and quality-of-life improvement was sustained during the 16-week study period, which is similar to findings of large community-based trials of three-times-weekly dosing. Once-weekly epoetin alfa was well tolerated, with most adverse events attributed to the underlying disease or concomitant chemotherapy. CONCLUSION: The results from this large, prospective, community-based trial suggest that once-weekly epoetin alfa therapy increases hemoglobin levels, decreases transfusion requirements, and improves quality of life in patients with cancer and anemia who undergo concomitant chemotherapy. Based on the results of this study, the clinical benefits and the adverse event profile of once-weekly epoetin alfa therapy in community-based practice are similar to those observed in the historical experience with the three-times-weekly dosage schedule.

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