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Effects of erythropoietin receptors and erythropoiesis-stimulating agents on disease progression in cancer.

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Aapro, M Jelkmann, W Constantinescu, Stefan N. [UCL] Leyland-Jones, B

Erythropoiesis-stimulating agents (ESAs) increase red blood cell (RBC) production in bone marrow by activating the erythropoietin receptor (EpoR) on erythrocytic-progenitor cells. Erythropoiesis-stimulating agents are approved in the United States and Europe for treating anaemia in cancer patients receiving chemotherapy based on randomised, placebo-controlled trials showing that ESAs reduce RBC transfusions. Erythropoiesis-stimulating agent-safety issues include thromboembolic events and concerns regarding whether ESAs increase disease progression and/or mortality in cancer patients. Several trials have reported an association between ESA use and increased disease progression and/or mortality, whereas other trials in the same tumour types have not provided similar findings. This review thoroughly examines available evidence regarding whether ESAs affect disease progression. Both clinical-trial data on ESAs and disease progression, and preclinical data on how ESAs could affect tumour growth are summarised. Preclinical topics include (i) whether tumour cells express EpoR and could be directly stimulated to grow by ESA exposure and (ii) whether endothelial cells express EpoR and could be stimulated by ESA exposure to undergo angiogenesis and indirectly promote tumour growth. Although assessment and definition of disease progression vary across studies, the current clinical data suggest that ESAs may have little effect on disease progression in chemotherapy patients, and preclinical data indicate a direct or indirect effect of ESAs on tumour growth is not strongly supported.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2012
Language Anglais
Journal information "The British journal of cancer" - Vol. 106, no. 7, p. 1249-1258 (2012)
Peer reviewed yes
Publisher Nature Publishing Group ((United Kingdom) [S.l.])
issn 0007-0920
e-issn 1532-1827
Publication status Publié
Affiliation UCL - SSS/DDUV - Institut de Duve
MESH Subject Anemia ; Clinical Trials as Topic ; Disease Progression ; Drug Evaluation, Preclinical ; Hematinics ; Humans ; Meta-Analysis as Topic ; Neoplasms ; Receptors, Erythropoietin
Links
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Bibliographic reference Aapro, M ; Jelkmann, W ; Constantinescu, Stefan N. ; Leyland-Jones, B. Effects of erythropoietin receptors and erythropoiesis-stimulating agents on disease progression in cancer.. In: The British journal of cancer, Vol. 106, no. 7, p. 1249-1258 (2012)
Permanent URL http://hdl.handle.net/2078/121149