A randomized comparison of every-2-week darbepoetin alfa and weekly epoetin alfa for the treatment of chemotherapy-induced anemia in patients with breast, lung, or gynecologic cancer.

An important trial by Schwartzberg et al. has recently been published in The Oncologist. In prospective manner, this trial tested the two erythropoietin preparations commonly used in the US, epoetin alfa and darbepoetin alfa, in their most commonly used doses and schemas in anemic cancer patients on chemotherapy. The two drugs performed with remarkably similar results across three common tumor types of breast, lung, and gyn cancers, although the authors hastened to point out that the trial was not powered to show non-inferiority between the two drugs. What the trial did show was that patients do have QOL improvements when hemoglobins rise up to hemoglobins of 12 g/dL and that both drugs are quite safe when used in this fashion. While the development of novel dosing schemas and doses of the erythropoietin preparations continues (and the role of iron among them), it is clear that improving hemoglobin in our patients with cancer and chemotherapy related anemia in order to maximize the QOL of our patients and their care givers should remain a major priority for the oncologist.

David H. Henry