The Use of ESAs in Patients With Breast Cancer

Brian Leyland-Jones, MBBS, PhD, director of Edith Sanford Breast Cancer Research, discusses the use of erythropoiesis stimulating agents (ESAs) in patients with breast cancer.

There has been a lot of controversy in this space. At the 2013 Breast Cancer Symposium, Leyland-Jones presented the latest meta-analysis, which looked at 9 current studies in breast cancer randomizing ESAs versus no ESAs.

Clinical Pearls

The meta-analysis looked at 5 endpoints and found that mortality increased 20% when using ESAs. In studies with target hemoglobin levels at or less than 12 grams per deciliter (g/dL), the hazard ratio was reduced to 1.03. Leyland-Jones says that when using ESAs, the target hemoglobin levels must be reduced to 12 g/dL to reduce the mortality rate.

• There has been a lot of controversy over the use of ESAs in breast cancer
• The latest meta-analysis looked at 9 current studies which randomized ESAs vs no ESAs