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IV iron and darbepoietin alfa well tolerated, resolved chemotherapy-induced anemia

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33rd Congress of the European Society for Medical Oncology

Adding intravenous iron to darbepoetin alfa once every three weeks may improve hematologic response in patients with chemotherapy-induced anemia, according to data presented at the 33rd Congress of the European Society for Medical Oncology in Stockholm.

Michael Auerbach, MD, in private practice in Baltimore and clinical professor of medicine at Georgetown University in Washington, presented data from a 15-week, phase-2 factorial study that analyzed the use of darbepoetin alfa (Aranesp, Amgen) with and without intravenous iron.

The study included 238 patients with chemotherapy-induced anemia. Most patients had lung, gastrointestinal or breast cancer. Patients were randomly assigned to darbepoetin alfa 500 mcg or 300 mcg once every three weeks with or without IV iron. The IV iron was given as a 400-mg infusion of low–molecular-weight iron dextran over 30 minutes, according to Auerbach. Target hemoglobin was >11 g/dL. Researchers conducted a double-blind evaluation of darbepoietin alfa use and conducted an open-label evaluation of the IV iron use.

According to Auerbach and colleagues, no significant interaction occurred between darbepoetin alfa dose and iron use.

Seventy-eight percent of patients assigned to 500 mcg and 75% of those assigned to 300 mcg achieved the target hemoglobin level. The researchers reported hematopoetic response for 76% of those assigned to 500 mcg and 69% of those assigned to 300 mcg darbepoetin alfa.

Seventy-two percent of patients who did not receive IV iron achieved the target hemoglobin level, compared with 82% of those who did receive IV iron. The percentage of patients with hematopoetic response was also higher for those who received IV iron, compared with those who did not (82% vs. 63%).

“ESAs in the western blood supply will be rescued once oncologists embrace the routine use of this clearly effective, routinely safe and inexpensive therapy,” Auerbach said during a press conference held at the meeting.

For more information:

• Auerbach M, Silberstein PT, Webb RT, et al. #LBA9. Presented at: the 33rd Congress of the European Society for Medical Oncology; Sept. 12-16, 2008; Stockholm.