Epoetin alfa
Epoetin alfa is a manufactured version of the kidney hormone that tells the bone marrow to make red blood cells. In cancer it treats anaemia caused by chemotherapy and reduces the need for transfusions, but it is used cautiously because it can shorten survival and cause clots.
Overview
Epoetin alfa was approved in June 1989 for anaemia of chronic kidney disease and in 1993 for anaemia due to concomitant myelosuppressive chemotherapy in non-myeloid malignancies when at least two further months of chemotherapy are planned; the biosimilar Retacrit followed in 2018 and the EU authorised the first epoetin biosimilars in 2007. Trials in the 2000s that targeted higher haemoglobin found worse survival and tumour progression in several cancers, leading to boxed warnings, the ESA APPRISE risk programme (2010 to 2017) and the current rule to use the lowest dose that avoids transfusion, never in patients treated with curative intent. Thromboembolism, hypertension and rare pure red cell aplasia are the safety concerns. Darbepoetin alfa is the long-acting alternative.
- AmivantamabApproved
- CamizestrantApproved
- Comprehensive genomic profilingStandard of care
- Liquid biopsy (ctDNA)Standard of care
- LorlatinibApproved
- MRD / molecular residual disease testingEstablished
- ADC payload neutralisersPhase 1
- BGB-16673Phase 3
- Bispecific ADCPhase 3
- BRUIN CLL-321Positive
- CaDAnCe-304Recruiting
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- A clone report from blood at every treatment cycle
- A fast route to the matched drug when it is licensed for another cancer
- A multi-cancer platform trial of adaptive (dose-holiday) therapy
- A national rapid research autopsy network for end-stage cancer
- A standard evolvability score for every tumour
- A standing platform trial that assigns treatment by how the tumour escaped
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance atlas: how tumours escape and what closes the route · Lines of therapy.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 1989 | Anaemia of chronic kidney disease |
| US | 1993 | Anaemia due to concomitant myelosuppressive chemotherapy in non-myeloid malignancies |
| EU | 2007 | First epoetin alfa biosimilars (Binocrit, Abseamed, Epoetin alfa Hexal) including chemotherapy-induced anaemia |
Trials
topRecruiting now (live from ClinicalTrials.gov)
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Latest papers
topQuery for this drug: (TITLE:"Epoetin alfa" OR ABSTRACT:"Epoetin alfa" OR TITLE:"Epogen" OR ABSTRACT:"Epogen" OR TITLE:"Procrit" OR ABSTRACT:"Procrit" OR TITLE:"Retacrit epoetin alfa-epbx" OR ABSTRACT:"Retacrit epoetin alfa-epbx" OR TITLE:"Eprex" OR ABSTRACT:"Eprex" OR TITLE:"Binocrit" OR ABSTRACT:"Binocrit") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Epoetin alfa, not a curated reading list.
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