Can Erythropoiesis-Stimulating Agents Increase Mortality in Patients With Cancer?

Bohlius J, Schmidlin K, Brillant C, et al
Lancet. 2009;373:1532-1542
SUMMARY
To determine the role of erythropoiesis-stimulating drugs, such as epoetin on patients with cancer, the study authors conducted a meta-analysis of 53 randomized trials involving almost 14,000 patients. The study included all common tumor types and patients of varying ages with varying degrees of anemia. The combined results showed that these drugs caused a 17% increase in overall mortality (P = .003) and a reduced survival (P = .046).The results appeared to be unchanged by different types of cancer therapy.
VIEWPOINT
One of the strengths of this study is that it was carried out on individual patient data from each trial, rather than on published results. Clinicians have used these compounds because they reduce patient fatigue and lesson the need for transfusions. However, this carefully conducted trial demonstrated that these improvements in quality of life must be balanced against the increased mortality and lower life expectancy.