Anemia Drugs Up Cancer Death Risk
Study Shows More Deaths, Blood Clots in Cancer Patients Taking Procrit, Epogen, Aranesp
WebMD News Archive
Anemia Drug Benefits Overrated, Risks Underrated? continued...
"We thought that receptor was found only on blood stem cells, so the
drugs' effects would be very precise," Lai tells WebMD. "But then we
saw that brain cells also had the receptor, and that the drugs help some blood
vessels to develop. And then someone got the idea to see if cancer cells have
it. Sure enough, all these different solid tumors express the
The effect on tumor cells, Lai says, is to help them invade deeper into the
Meanwhile, U.S. doctors began using more and more of the drugs. Instead of
using the drugs to bring patients' red blood cell counts up to minimum levels,
they began using it to bring blood cell counts as close to normal as possible.
Fueling the process was a rebate scheme in which the companies making the drugs
paid doctors millions of dollars to give the drugs to their patients.
"We had a class of drug approved for a very specific indication. But
through a variety of professional concerns and legitimate patient interests --
combined with heavy advertising and doctor-reimbursement policies -- we
expanded use of these drugs beyond their original intent," Len Lichtenfeld,
MD, deputy chief medical officer at the American Cancer Society, tells
The unchecked use of Procrit, Epogen, and Aranesp began to unravel in May
2006, when a research review by the U.S. Agency for Healthcare Research and
Quality showed that the drugs increased patients' risk of deadly blood
But Lichtenfeld says what really shocked cancer doctors was the FDA's
January 2007 release of a "Dear Health Care Professional" letter from
Aranesp maker Amgen. The letter informed doctors that cancer patients no longer
on chemotherapy but still taking Aranesp appeared to die more often than
patients not taking it.
Now the Bennett study confirms this suspicion -- and strongly suggests that
it applies to the entire class of ESA drugs.
Whither Procrit, Epogen, Aranesp?
Procrit, Epogen, and Aranesp are top-selling drugs. Until the mid-March FDA
panel meeting, it won't be clear exactly how doctors should use the