Safety and efficacy outcomes with erythropoiesisstimulating agents in patients with breast cancer: A meta-analysis

Matti Aapro, V. Moebus, U. Nitz, J. O'Shaughnessy, P. Pronzato, M. Untch, D. Tomita, C. Bohac, B. Leyland-Jones

Research output: Contribution to journalArticlepeer-review


Background: New data on erythropoiesis-stimulating agents (ESAs) regarding overall survival and disease progressionrelated outcomes in patients with breast cancer receiving chemotherapy are presented in a meta-analysis of controlled trials of ESA use (epoetin α, epoetin β, darbepoetin α, biosimilars). Patients and methods: A literature search identified reports from January 1997 through March 2014. We used company databases for Amgen, Inc., or Janssen studies and published data for other studies. Random-effects odds ratios (ORs) were calculated to compare results for patients randomized to ESA with those randomized to control. Results: Deaths were reported for 571 of 2346 patients (24%) in the ESA groups and 523 of 2367 patients (22%) in the control groups [OR, 1.20; 95% confidence interval (CI) 1.03-1.40]. Sensitivity analyses were conducted to explore the effects of individual studies and exclusion of one study (BEST) resulted in an OR for death of 1.12 (95% CI 0.94-1.34). In seven studies reporting progression-related end points (N = 4197; ESA n = 2088; control n = 2109), the OR was 1.01 (95% CI 0.87-1.16) for ESA compared with control. Conclusions: After incorporating recent results of ESA use in patients with breast cancer, risks of survival and progression-free survival remain consistent with previously published data.

Original languageEnglish
Pages (from-to)688-695
Number of pages8
JournalAnnals of Oncology
Issue number4
Publication statusPublished - Apr 1 2015


  • Breast cancer
  • Chemotherapy-induced anemia
  • Darbepoetin α
  • Epoetin α
  • Erythropoiesis-stimulating agents
  • Meta-analysis

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Medicine(all)


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