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Current Controversies and Recent Clinical Guidelines for use of Epoetin and Darbepoetin Lukas Wartman, M.D. November 2, 2007
Background of Erythropoiesis Stimulating Agents (ESAs): ,[object Object],[object Object],[object Object],[object Object]
Rudimentary Economics of the ESAs: ,[object Object],[object Object],[object Object],[object Object]
Overview of ESA Efficacy and Safety: ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Recent ESA Trials Reporting Adverse Outcomes:   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The ENHANCE Trial:  Henke et al. Lancet 2003; 362:1255-60. ,[object Object],[object Object],[object Object],[object Object],[object Object]
ENHANCE Trial Results: Locoregional Progression-free Survival R=0 R=1 or 2 1º XRT
ENHANCE Trial Results: ,[object Object],[object Object],[object Object]
Follow-up Analysis of Epo Receptors on Cancer Cells of ENHANCE Trial Patients: ,[object Object],[object Object],[object Object],[object Object],[object Object]
The BEST Trial:  Leyland-Jones et al. J Clin Oncol 23:5960-5972, 2005 . ,[object Object],[object Object],[object Object],[object Object],[object Object]
Leyland-Jones, B. et al. J Clin Oncol; 23:5960-5972 2005 Fig 1. Epoetin alfa dose adjustments

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ESA Guidelines for Cancer Anemia Management

  • 1. Current Controversies and Recent Clinical Guidelines for use of Epoetin and Darbepoetin Lukas Wartman, M.D. November 2, 2007
  • 2.
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  • 8. ENHANCE Trial Results: Locoregional Progression-free Survival R=0 R=1 or 2 1º XRT
  • 9.
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  • 12. Leyland-Jones, B. et al. J Clin Oncol; 23:5960-5972 2005 Fig 1. Epoetin alfa dose adjustments
  • 13. Leyland-Jones, B. et al. J Clin Oncol; 23:5960-5972 2005 Fig 2. Patient disposition (intent-to-treat [ITT] population, N = 939)
  • 14. Leyland-Jones, B. et al. J Clin Oncol; 23:5960-5972 2005 Fig 3. Kaplan-Meier estimate of long-term survival, with convergence of lines about 19 months after randomization (as of January 4, 2003; intent-to-treat [ITT] population, N = 939)
  • 15. Leyland-Jones, B. et al. J Clin Oncol; 23:5960-5972 2005 Fig 4. Mean hemoglobin level (95% CI) over time overall and by 12-month survival status (intent-to-treat [ITT] population, N = 939)
  • 16. Leyland-Jones, B. et al. J Clin Oncol; 23:5960-5972 2005 Fig 5. Time to disease progression (intent-to-treat population, N = 939)
  • 17.
  • 18. Wright, J. R. et al. J Clin Oncol; 25:1027-1032 2007 Fig 1. Consort flow chart
  • 19. Wright, J. R. et al. J Clin Oncol; 25:1027-1032 2007 Fig 2. Overall survival curve from time of random assignment
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