Anemia in Lung Cancer Patients Often Undertreated

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Researchers affiliated with the European Cancer Anaemia Survey (ECAS) have reported that approximately 50% of patients with lung cancer with anemia received appropriate treatment. The details of this report appeared in the December issue of Lung Cancer.

Anemia is a common finding in patients with lung cancer. It is due to the malignancy itself and to radiation and chemotherapy. Anemia can be treated by blood transfusions or one of the epoetins such as Procrit® (epoetin alfa) or Aranesp® (darbepoetin alfa). However, blood transfusion should be reserved for patients who do not respond to epoetin therapy.

This survey evaluated anemia in 2002 patients with lung cancer. Thirty-nine per cent were receiving chemotherapy, 31.7% were receiving combination treatment and 30.7% were receiving no treatment. A total of 37.6% were anemic at the time of enrollment in the survey. Anemia was present in over half the patients receiving platinum based chemotherapy and 31% of those receiving non-platinum regimens. Over 80% of patients developed anemia while receiving platinum-based therapy with an increase from 24% after the first cycle to 77% after cycle 6. They observed that only 47% of patients received treatment for anemia. Epoetin treatment was started when the average hemoglobin was 9 gms and transfusions were given when the average hemoglobin was 8.5 gms. Risk factors for anemia were identified as platinum treatment, female sex and initial hemoglobin level. These authors recommend earlier initiation of epoetin therapy and closer monitoring for anemia.

Comments: These are surprising findings given the widespread use of epoetins in the United States. It would be of interest to have a similar survey of U.S. patients to determine epoetin use here parallels the European experience.

Reference: Kosmidis P, Krzakowski M. Anemia profiles in patients with lung cancer: what have we learned from the European Cancer Anaemia Survey (ECAS)? Lung Cancer . 2005;50:401-412.