Gene/Protein
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Pivot Concepts:
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Target Concepts:
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Query: UMLS:C0684249 (
lung carcinoma
)
23,830
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Lung cancer is associated with the one of the highest rates of anaemia of all solid tumours. Anaemia has a negative impact on treatment outcome and overall survival of patients with cancer and also affects their quality of life. Recombinant human erythropoietin (epoetin) provides an effective and safe treatment of cancer-related anaemia without the risks associated with red blood cell transfusion.
Epoetin
therapy increases haemoglobin levels, reduces the need for blood transfusions and improves the quality of life of patients with anaemia and lung cancer. Epoetin beta is also effective for preventing the development of anaemia and decreasing transfusion requirements when administered with concomitant platinum-based chemotherapy. In addition, preliminary evidence suggests that treatment with erythropoietic agents may improve survival of lung cancer patients, although this needs to be verified in prospective clinical trials specifically designed to evaluate survival. Therefore, early initiation of epoetin beta to prevent chemotherapy-associated anaemia may represent the best strategy for patients with lung cancer being treated with chemotherapy.
Lung Cancer
2004 Nov
PMID:Role of epoetin in the management of anaemia in patients with lung cancer. 1547 62
Darbepoetin alfa
(
Aranesp
), Amgen) is a novel erythropoiesis-stimulating protein with a serum half-life longer than recombinant human erythropoietin (Epo), used in the treatment of cancer-associated anaemia. Anaemia is known to adversely affect prognosis and response to treatment in cancer patients. Solid tumours contain regions of hypoxia due to poor vascular supply and cellular compaction. Although hypoxic stress usually results in cell death, hypoxia-resistant tumour cells are genetically unstable and often acquire a drug-resistant phenotype. Increasing tumour oxygenation and perfusion during treatment could have the doubly beneficial outcome of reducing the fraction of treatment-resistant cells, while increasing drug delivery to previously hypoxic tissue. In this study, we examined the effect of darbepoetin alfa on chemotherapy sensitivity and delivery in an in vivo model of Lewis
lung carcinoma
, shown here to express the Epo receptor (EpoR). We identified that weekly darbepoetin alfa treatment, commencing 10 days before chemotherapy, resulted in a significant reduction in tumour volume compared to chemotherapy alone. This was mediated by the prevention of anaemia, a reduction in tumour hypoxia and a concomitant increase in drug delivery.
Darbepoetin alfa
treatment alone did not modulate the growth of the EpoR-expressing tumour cells. This study identifies an important role for darbepoetin alfa in increasing the therapeutic index of chemotherapy.
...
PMID:Correction of anaemia through the use of darbepoetin alfa improves chemotherapeutic outcome in a murine model of Lewis lung carcinoma. 1599
Darbepoetin alfa
, an erythropoiesis-stimulating agent (ESA), is used in cancer patients as a supportive care for anemia. For small-cell lung cancer (SCLC), several studies have shown that the administration of ESAs does not affect survival but decreases the need for blood transfusions and improves the quality of life (QOL) of patients receiving chemotherapy. The present randomized phase II study assessed the feasibility, efficacy, and safety of the administration of darbepoetin alfa to patients with SCLC receiving dose-dense (every 2 weeks) standard chemotherapy consisting of carboplatin plus etoposide, pegfilgrastim prophylactically. Seventy-four chemotherapy-naive patients with limited or extensive SCLC received combination chemotherapy for 6 cycles, and half of the patients additionally received darbepoetin to achieve a target hemoglobin concentration of 12-13 g/dL. The primary study outcome, progression-free survival, showed no difference between the 2 arms of the study. Among the secondary endpoints, objective response was similar in the presence and absence of darbepoetin (best response rates = 75.0% vs. 77.8%). Likewise, 1-year survival rates were not different between the 2 treatment arms (40.1% vs. 45.9%). There were no significant differences in grade 3/4 toxicities. As expected, the need for blood transfusions differed significantly: 19.4% of patients in the darbepoetin arm received transfusions versus 38.9% in the control arm. Analysis of European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30) scales at different time points showed that the darbepoetin group's QOL was significantly better for certain readouts and never significantly worse than that of the control group. Thus, the combination of darbepoetin alfa with dose-dense carboplatin plus etoposide was feasible and well tolerated. Addition of darbepoetin alfa to chemotherapy lowered the need for blood transfusions and did not affect measures of survival and objective response.
Clin
Lung Cancer
2011 Jan
PMID:Addition of darbepoetin alfa to dose-dense chemotherapy: results from a randomized phase II trial in small-cell lung cancer patients receiving carboplatin plus etoposide. 2127 82