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Thread: Alternatives to EPO Prior to Stomach Cancer Operation

  1. #1
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    Alternatives to EPO Prior to Stomach Cancer Operation

    Hello

    My friend has just been diagnosed with stomach cancer. She is diabetic and insulin dependant. Her blood count is now 7.1 but not increasing. Doctors don't want to give her EPO early on, as the stomach cancer feeds off it.

    Is there an alternative to EPO that can be given?

    Thank you very very much.

    This site is very useful.

    Emma

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  3. #2
    Registered User Informaticus's Avatar
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    But here's an article that suggests that the use of erythropoiesis-stimulating agents (of which EPO is one) do not appear to have any negative effect on the progression of cancers or on survival.

    Access : Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes : British Journal of Cancer

    British Journal of Cancer 102, 301315 (19 January 2010)

    Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes

    J Glaspy, J Crawford, J Vansteenkiste, D Henry, S Rao, P Bowers, J A Berlin, D Tomita, K Bridges, & H Ludwig
    Abstract

    BACKGROUND: Cancer patients often develop the potentially debilitating condition of anaemia. Numerous controlled studies indicate that erythropoiesis-stimulating agents (ESAs) can raise haemoglobin levels and reduce transfusion requirements in anaemic cancer patients receiving chemotherapy. To evaluate recent safety concerns regarding ESAs, we carried out a meta-analysis of controlled ESA oncology trials to examine whether ESA use affects survival, disease progression and risk of venous-thromboembolic events. METHODS: This meta-analysis included studies from the 2006 Cochrane meta-analysis, studies published|[sol]|updated since the 2006 Cochrane report, and unpublished trial data from Amgen and Centocor Ortho Biotech. The 60 studies analysed (15|[thinsp]|323 patients) were conducted in the settings of chemotherapy|[sol]|radiochemotherapy, radiotherapy only treatment or anaemia of cancer. Data were summarised using odds ratios (ORs) with 95|[percnt]| confidence intervals (CIs). RESULTS: Results indicated that ESA use did not significantly affect mortality (60 studies: OR|[equals]|1.06; 95|[percnt]| CI: 0.971.15) or disease progression (26 studies: OR|[equals]|1.01; 95|[percnt]| CI: 0.901.14), but increased the risk for venous-thromoboembolic events (44 studies: OR|[equals]|1.48; 95|[percnt]| CI: 1.281.72). CONCLUSION: Though this meta-analysis showed no significant effect of ESAs on survival or disease progression, prospectively designed, future randomised clinical trials will further examine the safety and efficacy of ESAs when used according to the revised labelling information. British Journal of Cancer (2010) 102, 301315; doi:10.1038/sj.bjc.6605498 British Journal of Cancer Published online 5 January 2010

  4. #3
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    Thank you very much for the information, it's very very useful in that it's published on the 5th Jan 2010.

    I think this site is a fantastic source of information, and have used it to help me complete my blood card.

    One of the people that wrote the article J Glspy, I don't know whether you know this but is he one of the people interviewed on the JW video? I will have to have a look.

    Thanks very much, I will pass this information on to my friend.

    Emma

  5. #4
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    Hi

    I replied to this but not sure if it worked. Thank you very very much for this information, it is very useful with it being published on the 5th Janurary 2010. Brilliant, I will give it to my friend.

    One of the authors J Glaspy rings a bell. I don't know whether you know or not, but was he one of the people mentioned on the JW video?

    I have found this site very useful for making my own decisions on treatment of blood and filling in my Advanced Directive.

    Thank you

    Emma



    Quote Originally Posted by Informaticus View Post
    But here's an article that suggests that the use of erythropoiesis-stimulating agents (of which EPO is one) do not appear to have any negative effect on the progression of cancers or on survival.

    Access : Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes : British Journal of Cancer

    British Journal of Cancer 102, 301315 (19 January 2010)

    Erythropoiesis-stimulating agents in oncology: a study-level meta-analysis of survival and other safety outcomes

    J Glaspy, J Crawford, J Vansteenkiste, D Henry, S Rao, P Bowers, J A Berlin, D Tomita, K Bridges, & H Ludwig
    Abstract


    BACKGROUND: Cancer patients often develop the potentially debilitating condition of anaemia. Numerous controlled studies indicate that erythropoiesis-stimulating agents (ESAs) can raise haemoglobin levels and reduce transfusion requirements in anaemic cancer patients receiving chemotherapy. To evaluate recent safety concerns regarding ESAs, we carried out a meta-analysis of controlled ESA oncology trials to examine whether ESA use affects survival, disease progression and risk of venous-thromboembolic events. METHODS: This meta-analysis included studies from the 2006 Cochrane meta-analysis, studies published|[sol]|updated since the 2006 Cochrane report, and unpublished trial data from Amgen and Centocor Ortho Biotech. The 60 studies analysed (15|[thinsp]|323 patients) were conducted in the settings of chemotherapy|[sol]|radiochemotherapy, radiotherapy only treatment or anaemia of cancer. Data were summarised using odds ratios (ORs) with 95|[percnt]| confidence intervals (CIs). RESULTS: Results indicated that ESA use did not significantly affect mortality (60 studies: OR|[equals]|1.06; 95|[percnt]| CI: 0.971.15) or disease progression (26 studies: OR|[equals]|1.01; 95|[percnt]| CI: 0.901.14), but increased the risk for venous-thromoboembolic events (44 studies: OR|[equals]|1.48; 95|[percnt]| CI: 1.281.72). CONCLUSION: Though this meta-analysis showed no significant effect of ESAs on survival or disease progression, prospectively designed, future randomised clinical trials will further examine the safety and efficacy of ESAs when used according to the revised labelling information. British Journal of Cancer (2010) 102, 301315; doi:10.1038/sj.bjc.6605498 British Journal of Cancer Published online 5 January 2010

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