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I read it in a recent Ralph Moss's newsletter and then also in my

local newspaper. I just made a search online and found an article

describing the study (see it below but as far as I remember the

article in the newspaper was longer and also mentioned some in vitro

tests). Here's an extract: " Compared with the placebo group,

patients receiving epoetin beta were 62% more likely to have

progression of their cancer and die. " And just a couple of weeks ago

I saw a TV ad (on one of the main networks and at best time - ~7pm)

that advertised epogen for people undergoing chemo! I can imagine

how loud medical establishment would protest if somebody tried to put

a TV ad about pau d'arco or flaxseed oil+cc, for example. They would

say there are no proof and no studies and so on, but here's a study

that actually says a drug similar to epogen is harmful and they still

advertise it without any problems!

 

 

Anemia Drug May Hurt Cancer Treatment

Worse Survival, Cancer Control Seen With Cancer-Related Anemia Drug

 

WebMD Medical News Reviewed By Michael Smith, MD

on Saturday,

 

Treatments for cancer-related anemia may actually

worsen cancer survival in some patients, say researchers.

 

However, experts offer caution in interpreting these study results,

which appear in the Oct. 18 issue of The Lancet. They point out

several problems with the study that could have led to misleading

results as well as the inability to extrapolate these findings to

other cancers and clinical situations.

 

In addition to improving cancer-related anemia, these drugs were

thought to possibly improve cancer survival by improving response to

chemotherapy and radiation.

 

The researchers wanted to test whether treating cancer-related anemia

in patients receiving radiation therapy would improve delivery of

oxygen to the body and make treatments more effective, but it didn't,

lead researcher Michael Henke, MD, tells WebMD. He is vice chairman

of radiation oncology at the University of Freiburg in Germany.

 

Similar Drugs, Different Effects

 

The drug in the study -- called epoetin beta -- is similar to but not

exactly the same as two other drugs used for cancer-related anemia in

the U.S. Currently available treatments are Epogen and Procrit --

known generically as epoetin alfa. These drugs work by increasing

production of oxygen-carrying red blood cells. Manufacturer Hoffmann-

La Roche supplied the drug used in this study.

 

In the study, conducted in Austria, Germany, France, and Switzerland,

351 patients receiving radiation therapy for mouth and throat cancers

were given either epoetin beta or a placebo.

 

The researchers found that epoetin beta corrected cancer-related

anemia in patients undergoing radiation therapy for mouth and throat

cancers. However, it did not improve cancer control or survival.

 

In fact, Henke says, the drug appeared to worsen cancer control in

these patients. Compared with the placebo group, patients receiving

epoetin beta were 62% more likely to have progression of their cancer

and die.

 

" These findings are intriguing, concerning, and surprising, " Douglas

Rizzo, MD, associate professor of hematology/oncology at the Medical

College of Wisconsin in Milwaukee, tells WebMD.

 

But he has some concerns about how the researchers presented their

study results. For example, even though about 350 patients were

enrolled in the study, results were presented only for about 150

patients because the others were not treated according to study

protocol. Rizzo notes that this makes it difficult to fully

understand what the study is telling us.

 

Despite this and other concerns, Rizzo concludes that " I think it's

likely or at least possible that these findings are true. "

 

Conflicting Research

 

But why would the results of this trial differ from those of previous

studies suggesting benefits of drugs for cancer-related anemia beyond

its effect on anemia?

 

Henke cites differences in how earlier studies were done compared

with this newer, more powerful study. In addition, many previous

studies looked at quality of life rather than survival or cancer

control, he says.

 

Because this study was done exclusively in patients receiving

radiation therapy for cancers of the mouth and throat, Rizzo warns

against extrapolating these findings to patients receiving

chemotherapy or to those with other types of cancer.

 

Henke says that his study did not address the effect of cancer-

related anemia drugs in other settings but he believes that the

results would be similar.

 

Similarly, he says he doubts these findings are specific to the

epoetin beta used in this study, referring to a study in the August

issue of The Lancet showing a negative effect of epoetin alfa in

women with breast cancer. " If epoetin stimulates tumor growth, it

shouldn't matter which specific compound you use, " Henke says.

 

Experts Agree

 

How and when should these findings be applied to clinical practice?

All experts interviewed by WebMD agreed on the need for additional

well-controlled trials as well as for long-term follow-up on patients

already receiving epoetin in ongoing studies.

 

" This alarming, well-performed study and the recent report of a

prematurely terminated breast cancer study should alert and give rise

to concern to all investigators working in the field of epoetin

treatment for cancer-related anemia, " Michael Hedenus, MD, head of

hematology at County Hospital in Sundsvall, Sweden, tells WebMD.

 

However, he's not convinced that these findings would be the same for

different cancers.

 

Hedenus has received unrestricted research funds from Roche and has

given lectures paid for by Roche and Amgen (maker of Procrit). Roche

and Amgen are WebMD sponsors.

 

" We have to remember that cancers consist of different entities, each

with its own biology and responsiveness to different [body chemicals]

and hormones, " Hedenus says.

 

Hedenus has performed studies on the effect of epoetin on anemia

related to blood cancers and says he is not aware of disease

progression or deaths linked to epoetin. On the contrary, he cites

his own study and two others suggesting either no effect or an

improvement on survival for epoetin compared with placebo.

 

Studies on epoetin have shown that treatment of cancer-related anemia

decreases the need for blood transfusions and improves quality of

life, Tim J. Littlewood, MD, hematologist at the John Radcliffe

Hospital in Oxford, England, tells WebMD. Littlewood has received

consulting and lecture fees from three of the companies that make

various forms of epoetin.

 

" There have also been some very interesting, but unproven,

suggestions that [epoetin] treatment might not only have a positive

impact on quality of life but also on life expectancy, " he

says. " There is no reason to change this practice based on this one

paper in a group of patients with just one type of tumor. "

 

With reporting by Laurie Barclay, MD.

 

----

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SOURCES: The Lancet, Oct. 18, 2003; vol 362: pp 1255-1260. Michael

Henke, MD, vice chairman of radiation oncology, University of

Freiburg, Germany. Douglas Rizzo, MD, associate professor of

hematology/oncology, Medical College of Wisconsin, Milwaukee. Michael

Hedenus, MD, head of hematology, County Hospital, Sundsvall, Sweden.

 

© 2003 WebMD Inc. All rights reserved.