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Собственный опыт использования эпоэтина-a (Эральфон®) в лечении анемии, индуцированной воздействием цитостатиков
Собственный опыт использования эпоэтина-a (Эральфон®) в лечении анемии, индуцированной воздействием цитостатиков
Большакова С.А., Бычков Ю.М., Казарова М.В. Собственный опыт использования эпоэтина-a (Эральфон®) в лечении анемии, индуцированной воздействием цитостатиков. Современная Онкология. 2017; 19 (1): 80–84.
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Аннотация
Эпоэтин-a относится к препаратам, стимулирующим эритропоэз, в настоящее время их используют также для лечения анемии, индуцированной воздействием цитостатиков.
Материалы и методы. 124 пациента с различными солидными опухолями и уровнем гемоглобина ниже 120 г/л получили эпоэтин-a (Эральфон®) 10 000 МЕ или 12 000 МЕ 3 раза в неделю. Произведена оценка повышения уровня гемоглобина, а также оценка фармакоэкономической эффективности применения разных доз препарата.
Результаты. Было отмечено, что при проведении химиотерапии с включением в схемы лечения препаратов платины уровень гемоглобина достоверно быстрее повышается при использовании препарата Эральфон® 12 000 МЕ. Для пациентов с массой тела менее 70 кг с экономической точки зрения выгодно использовать Эральфон® 10 000 МЕ, 70 кг и более – Эральфон® 12 000 МЕ. Профиль безопасности обеих дозировок достаточно благоприятный.
Ключевые слова: эпоэтин-a, гемоглобин, солидные опухоли, фармакоэкономика.
Patients and methods. 124 patients with various solid tumors and a hemoglobin level <120 g/l received epoetin-a (Eralfon®) 10 000 ME or 12 000 ME three times a week. An evaluation of the increase in hemoglobin level was made, as well as an assessment of the pharmacoeconomic efficacy of various dosage forms.
Results. It was noted that during chemotherapy with platinum, the hemoglobin level significantly increases with the use of an Eralfon® 12 000 ME. For patients weighing <70 kg, it is economically advantageous to use Eralfon® 10 000 ME, for patients ≥70 kg – Eralfon®
12 000 ME. The safety profile of both dosages is quite favorable.
Key word: epoetin-a, hemoglobin, solid tumors, pharmacoeconomic.
Материалы и методы. 124 пациента с различными солидными опухолями и уровнем гемоглобина ниже 120 г/л получили эпоэтин-a (Эральфон®) 10 000 МЕ или 12 000 МЕ 3 раза в неделю. Произведена оценка повышения уровня гемоглобина, а также оценка фармакоэкономической эффективности применения разных доз препарата.
Результаты. Было отмечено, что при проведении химиотерапии с включением в схемы лечения препаратов платины уровень гемоглобина достоверно быстрее повышается при использовании препарата Эральфон® 12 000 МЕ. Для пациентов с массой тела менее 70 кг с экономической точки зрения выгодно использовать Эральфон® 10 000 МЕ, 70 кг и более – Эральфон® 12 000 МЕ. Профиль безопасности обеих дозировок достаточно благоприятный.
Ключевые слова: эпоэтин-a, гемоглобин, солидные опухоли, фармакоэкономика.
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Patients and methods. 124 patients with various solid tumors and a hemoglobin level <120 g/l received epoetin-a (Eralfon®) 10 000 ME or 12 000 ME three times a week. An evaluation of the increase in hemoglobin level was made, as well as an assessment of the pharmacoeconomic efficacy of various dosage forms.
Results. It was noted that during chemotherapy with platinum, the hemoglobin level significantly increases with the use of an Eralfon® 12 000 ME. For patients weighing <70 kg, it is economically advantageous to use Eralfon® 10 000 ME, for patients ≥70 kg – Eralfon®
12 000 ME. The safety profile of both dosages is quite favorable.
Key word: epoetin-a, hemoglobin, solid tumors, pharmacoeconomic.
Полный текст
Список литературы
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2. Rodgers GM, Becker PS, Blinder M et al. Cancer – and chemotherapy-induced anemia. J Natl Copmr Canc Netw 2012; 10 (5): 628–53.
3. Wood PA, Hrushesky WJ. Cisplatin-associated anemia: an erythropoietin deficiency syndrome. J Clin Invest 1995; 95 (4): 1650–9.
4. Bohlius J, Weingart O, Trelle S, Engert A. Cancer-related anemia and recombinant human erythropoietin – an update overview. Nat Clin Pract Oncol 2006; 3 (3): 152–64.
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13. Klein HG, Spahn DR, Carson JL. Red blood cell transfusion in clinical practice. Lancet 2007; 379 (9585): 415–26.
14. Broudy VC, Lin N, Brice M et al. Erythropoietin receptor characteristics on primary human erythroid cells. Blood 1991; 77: 2583–90.
15. Witthuhn BA, Quelle FW, Silvennoinen O et al. JAK2 associated with erythropoietin receptor and is tyrosine phosphorylated and activated following stimulation with erythropoietin. Cell 1993; 74: 227–36.
16. Huang LJ, Constantinescu SN, Lodish HF. The N-terminal domain of Janus kinase 2 is required for Golgi processing and cell surface expression of erythropoietin receptor. Mol Cell 2001; 8: 1327–38.
17. Jelkmann W, Bohlius J, Hallek M et al. The erythropoietin receptor in normal and cancer tissues. Crit Rev Oncol Hematol 2008; 67: 39–61.
18. Bennett CL, Silver SM, Djulbegovic B et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer – related anemia. JAMA 2008; 299 (8): 914–24.
19. European Medicines Agency. Neorecormon. Available from: http:www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000116/human_med_0000921.jsp&am....
20. Rizzo JD, Somerfield MR, Hagerty KL et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology. American Society of Hematology clinical practice guideline update. J Clin Oncol 2008; 26 (1): 132–49.
2. Rodgers GM, Becker PS, Blinder M et al. Cancer – and chemotherapy-induced anemia. J Natl Copmr Canc Netw 2012; 10 (5): 628–53.
3. Wood PA, Hrushesky WJ. Cisplatin-associated anemia: an erythropoietin deficiency syndrome. J Clin Invest 1995; 95 (4): 1650–9.
4. Bohlius J, Weingart O, Trelle S, Engert A. Cancer-related anemia and recombinant human erythropoietin – an update overview. Nat Clin Pract Oncol 2006; 3 (3): 152–64.
5. Spivak JL. The anemia of cancer: death by thousand cuts. Nat Rev Cancer 2005; 5 (7): 543–55.
6. Miller CB, Jones RJ, Pinatadosi S et al. Decreased erythropoietin response in patients with anemia of cancer. N Engl J Med 1990; 322 (24): 1689–92.
7. Ludwig H, Strasser K. Symptomatology of anemia. Semin Oncol 2001; 28 (2 Suppl. 8): 7–14.
8. Van Belle SJ-P, Cocquyt V. Impact of haemoglobin levels on the outcome of cancers treated with chemotherapy. Crit Rev Oncol Hematol 2003; 47 (1): 1–11.
9. Blomer J-U, Dunst J, Harrison L et al. Cancer-related anemia: biological findings, clinical implications and impact on quality of life. Oncology 2005; 68 (Suppl. 1): 12–21.
10. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 2001; 91 (12): 2214–21.
11. Nissman B, Barak V, Hubert A et al. Prognostic factors for survival in metastatic breast cancer during first-line paclitaxel chemotherapy. Anticancer Res 2003; 23 (2C): 1939–42.
12. Hauser CA, Stockler MR, Tattersall MHN. Prognostic factors in patients with recently diagnosed incurable cancer: a systemic review. Support Care Cancer 2006; 14 (10): 999–1011.
13. Klein HG, Spahn DR, Carson JL. Red blood cell transfusion in clinical practice. Lancet 2007; 379 (9585): 415–26.
14. Broudy VC, Lin N, Brice M et al. Erythropoietin receptor characteristics on primary human erythroid cells. Blood 1991; 77: 2583–90.
15. Witthuhn BA, Quelle FW, Silvennoinen O et al. JAK2 associated with erythropoietin receptor and is tyrosine phosphorylated and activated following stimulation with erythropoietin. Cell 1993; 74: 227–36.
16. Huang LJ, Constantinescu SN, Lodish HF. The N-terminal domain of Janus kinase 2 is required for Golgi processing and cell surface expression of erythropoietin receptor. Mol Cell 2001; 8: 1327–38.
17. Jelkmann W, Bohlius J, Hallek M et al. The erythropoietin receptor in normal and cancer tissues. Crit Rev Oncol Hematol 2008; 67: 39–61.
18. Bennett CL, Silver SM, Djulbegovic B et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer – related anemia. JAMA 2008; 299 (8): 914–24.
19. European Medicines Agency. Neorecormon. Available from: http:www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000116/human_med_0000921.jsp&am....
20. Rizzo JD, Somerfield MR, Hagerty KL et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology. American Society of Hematology clinical practice guideline update. J Clin Oncol 2008; 26 (1): 132–49.
2. Rodgers GM, Becker PS, Blinder M et al. Cancer – and chemotherapy-induced anemia. J Natl Copmr Canc Netw 2012; 10 (5): 628–53.
3. Wood PA, Hrushesky WJ. Cisplatin-associated anemia: an erythropoietin deficiency syndrome. J Clin Invest 1995; 95 (4): 1650–9.
4. Bohlius J, Weingart O, Trelle S, Engert A. Cancer-related anemia and recombinant human erythropoietin – an update overview. Nat Clin Pract Oncol 2006; 3 (3): 152–64.
5. Spivak JL. The anemia of cancer: death by thousand cuts. Nat Rev Cancer 2005; 5 (7): 543–55.
6. Miller CB, Jones RJ, Pinatadosi S et al. Decreased erythropoietin response in patients with anemia of cancer. N Engl J Med 1990; 322 (24): 1689–92.
7. Ludwig H, Strasser K. Symptomatology of anemia. Semin Oncol 2001; 28 (2 Suppl. 8): 7–14.
8. Van Belle SJ-P, Cocquyt V. Impact of haemoglobin levels on the outcome of cancers treated with chemotherapy. Crit Rev Oncol Hematol 2003; 47 (1): 1–11.
9. Blomer J-U, Dunst J, Harrison L et al. Cancer-related anemia: biological findings, clinical implications and impact on quality of life. Oncology 2005; 68 (Suppl. 1): 12–21.
10. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 2001; 91 (12): 2214–21.
11. Nissman B, Barak V, Hubert A et al. Prognostic factors for survival in metastatic breast cancer during first-line paclitaxel chemotherapy. Anticancer Res 2003; 23 (2C): 1939–42.
12. Hauser CA, Stockler MR, Tattersall MHN. Prognostic factors in patients with recently diagnosed incurable cancer: a systemic review. Support Care Cancer 2006; 14 (10): 999–1011.
13. Klein HG, Spahn DR, Carson JL. Red blood cell transfusion in clinical practice. Lancet 2007; 379 (9585): 415–26.
14. Broudy VC, Lin N, Brice M et al. Erythropoietin receptor characteristics on primary human erythroid cells. Blood 1991; 77: 2583–90.
15. Witthuhn BA, Quelle FW, Silvennoinen O et al. JAK2 associated with erythropoietin receptor and is tyrosine phosphorylated and activated following stimulation with erythropoietin. Cell 1993; 74: 227–36.
16. Huang LJ, Constantinescu SN, Lodish HF. The N-terminal domain of Janus kinase 2 is required for Golgi processing and cell surface expression of erythropoietin receptor. Mol Cell 2001; 8: 1327–38.
17. Jelkmann W, Bohlius J, Hallek M et al. The erythropoietin receptor in normal and cancer tissues. Crit Rev Oncol Hematol 2008; 67: 39–61.
18. Bennett CL, Silver SM, Djulbegovic B et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer – related anemia. JAMA 2008; 299 (8): 914–24.
19. European Medicines Agency. Neorecormon. Available from: http:www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000116/human_med_0000921.jsp&am....
20. Rizzo JD, Somerfield MR, Hagerty KL et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology. American Society of Hematology clinical practice guideline update. J Clin Oncol 2008; 26 (1): 132–49.
________________________________________________
2. Rodgers GM, Becker PS, Blinder M et al. Cancer – and chemotherapy-induced anemia. J Natl Copmr Canc Netw 2012; 10 (5): 628–53.
3. Wood PA, Hrushesky WJ. Cisplatin-associated anemia: an erythropoietin deficiency syndrome. J Clin Invest 1995; 95 (4): 1650–9.
4. Bohlius J, Weingart O, Trelle S, Engert A. Cancer-related anemia and recombinant human erythropoietin – an update overview. Nat Clin Pract Oncol 2006; 3 (3): 152–64.
5. Spivak JL. The anemia of cancer: death by thousand cuts. Nat Rev Cancer 2005; 5 (7): 543–55.
6. Miller CB, Jones RJ, Pinatadosi S et al. Decreased erythropoietin response in patients with anemia of cancer. N Engl J Med 1990; 322 (24): 1689–92.
7. Ludwig H, Strasser K. Symptomatology of anemia. Semin Oncol 2001; 28 (2 Suppl. 8): 7–14.
8. Van Belle SJ-P, Cocquyt V. Impact of haemoglobin levels on the outcome of cancers treated with chemotherapy. Crit Rev Oncol Hematol 2003; 47 (1): 1–11.
9. Blomer J-U, Dunst J, Harrison L et al. Cancer-related anemia: biological findings, clinical implications and impact on quality of life. Oncology 2005; 68 (Suppl. 1): 12–21.
10. Caro JJ, Salas M, Ward A, Goss G. Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 2001; 91 (12): 2214–21.
11. Nissman B, Barak V, Hubert A et al. Prognostic factors for survival in metastatic breast cancer during first-line paclitaxel chemotherapy. Anticancer Res 2003; 23 (2C): 1939–42.
12. Hauser CA, Stockler MR, Tattersall MHN. Prognostic factors in patients with recently diagnosed incurable cancer: a systemic review. Support Care Cancer 2006; 14 (10): 999–1011.
13. Klein HG, Spahn DR, Carson JL. Red blood cell transfusion in clinical practice. Lancet 2007; 379 (9585): 415–26.
14. Broudy VC, Lin N, Brice M et al. Erythropoietin receptor characteristics on primary human erythroid cells. Blood 1991; 77: 2583–90.
15. Witthuhn BA, Quelle FW, Silvennoinen O et al. JAK2 associated with erythropoietin receptor and is tyrosine phosphorylated and activated following stimulation with erythropoietin. Cell 1993; 74: 227–36.
16. Huang LJ, Constantinescu SN, Lodish HF. The N-terminal domain of Janus kinase 2 is required for Golgi processing and cell surface expression of erythropoietin receptor. Mol Cell 2001; 8: 1327–38.
17. Jelkmann W, Bohlius J, Hallek M et al. The erythropoietin receptor in normal and cancer tissues. Crit Rev Oncol Hematol 2008; 67: 39–61.
18. Bennett CL, Silver SM, Djulbegovic B et al. Venous thromboembolism and mortality associated with recombinant erythropoietin and darbepoetin administration for the treatment of cancer – related anemia. JAMA 2008; 299 (8): 914–24.
19. European Medicines Agency. Neorecormon. Available from: http:www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000116/human_med_0000921.jsp&am....
20. Rizzo JD, Somerfield MR, Hagerty KL et al. Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology. American Society of Hematology clinical practice guideline update. J Clin Oncol 2008; 26 (1): 132–49.
Авторы
С.А.Большакова*, Ю.М.Бычков, М.В.Казарова
ФГБУ «Российский научный центр рентгенорадиологии» Минздрава России. 117997, Россия, Москва, ул. Профсоюзная, д. 86
*bolshakovasvetlana@rambler.ru
Russian Scientific Center of Roentgenoradiology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Profsoiuznaia, d. 86
*bolshakovasvetlana@rambler.ru
ФГБУ «Российский научный центр рентгенорадиологии» Минздрава России. 117997, Россия, Москва, ул. Профсоюзная, д. 86
*bolshakovasvetlana@rambler.ru
________________________________________________
Russian Scientific Center of Roentgenoradiology of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Profsoiuznaia, d. 86
*bolshakovasvetlana@rambler.ru
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