Recombinant human erythropoietin and platinum-based chemotherapy in advanced ovarian cancer

Patients with ovarian cancer often experience dose-limiting myelotoxicity, nephrotoxicity and anemia following treatment with platinum-based chemotherapy.

To investigate the ability of recombinant human erythropoietin (epoetin alfa) to prevent the development of anemia, 30 patients with advanced ovarian carcinoma receiving cisplatin or carboplatin were randomly assigned to treatment with subcutaneous epoetin alfa 300 IU/kg three times a week in addition to conventional supportive treatment, or conventional supportive treatment alone, for up to six chemotherapy cycles. The dose of epoetin alfa was reduced if hemoglobin concentration exceeded 15 g/dL.

A highly significant difference in mean hemoglobin concentrations was observed between the two groups during the first cycle of chemotherapy due to a significant decrease in mean hemoglobin concentration in the control group. A maximal difference of 3.4 g/dL was achieved during cycle three. Fewer patients required blood or platelet transfusions in the epoetin alfa-treated group, although the difference was not significant compared to the control group. Epoetin alfa was well tolerated.

Epoetin alfa appears to be effective and well tolerated in preventing hemoglobin decline in patients undergoing aggressive cyclic platinum-based chemotherapy for advanced ovarian carcinoma.