Anemia Drugs Up Cancer Death Risk
Study Shows More Deaths, Blood Clots in Cancer Patients Taking Procrit, Epogen, Aranesp
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Whither Procrit, Epogen, Aranesp? continued...
"This is like the HRT [hormone replacement therapy] story," Lichtenfeld says. "Several years ago, research suggested HRT had significant side effects and not as much benefit as thought. The pendulum swung from very many women using HRT to very few women using HRT. But now a balance has been achieved, where there is not so much HRT use as in the past, but still a major if limited role for the treatment. With ESAs, we will come to a similar conclusion. But for now, use will be very conservative."
Lai says Procrit, Epogen, and Aranesp have complex effects on tumors -- effects that are not yet fully known. The drugs seem to have different effects on different tumors.
"I don't think these drugs have a huge overall effect on tumor progression, but they definitely do make a contribution to the disease," he says. "The size of that contribution still needs to be completely understood."
Lai worries that while researchers figure this out, oncologists -- and their patients -- will be denied a useful class of drugs.
"I think the fear among oncologists is that the ESAs may just be removed from all cancer indications, and I don't know that is the best decision," he says. "You begin with patients with severe cancers who have severe treatment-related side effects. You have to balance the benefits of ESAs against the risks of what could happen to a patient's tumors if you use the drugs."
Bennett, Lai, and colleagues report their findings in the Feb. 27 issue of The Journal of the American Medical Association.