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Erythropoietin treatment in chemotherapy-induced anemia in previously untreated advanced esophagogastric cancer patients . BACKGROUND The impact of erythropoiesis-stimulating agents in chemotherapy-induced anemia has been a constant topic of debate over recent years . We prospectively assessed the efficacy of epoetin beta ( Epo-b ) in improving hemoglobin ( Hb ) levels and outcome in patients within an open label , randomized clinical phase II trial with advanced or metastatic gastric/esophagogastric cancer . METHODS Previously untreated patients were randomized to receive 3-weekly cycles of capecitabine ( 1000 mg/m ( 2 ) bid ) for 14 days plus on day 1 either irinotecan 250 mg/m ( 2 ) or cisplatin 80 mg/m ( 2 ) . Epo-b ( 30000 IU once weekly ) was initiated in patients with Hb < 11 g/dl and continued until Hb ≥12 g/dl was reached . If after 4 weeks the Hb increase was < 0.5 g/dl , Epo-b was increased to 30000 IU , twice weekly . RESULTS Of 118 patients enrolled , 32 received Epo-b treatment ; of these , 65 % achieved an increase in Hb levels of at least 2 g/dl , with 74 % achieving the target Hb of ≥12 g/dl . Within the study population , patients receiving Epo-b showed better overall survival ( median 14.5 vs. 8.0 months , P = 0.056 ) as well as a significantly improved disease control rate ( 78 vs. 55 % , P = 0.025 ) . Patients in the irinotecan group profited significantly ( P < 0.05 ) in terms of progression-free survival and overall survival under Epo-b treatment ( median 6.5 vs 4.1 months and median 15.4 vs 8.4 months , respectively ) . CONCLUSIONS Epo-b was effective in raising Hb levels in patients with advanced esophagogastric cancer . Patients receiving Epo-b had a significantly increased response to chemotherapy and a clear trend to improved survival .
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Intervention_Pharmacological
capecitabine
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Intervention_Pharmacological
irinotecan
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Intervention_Pharmacological
cisplatin
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Intervention_Pharmacological
Epo-b
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Outcome_Physical
hemoglobin ( Hb ) levels
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Outcome_Physical
Hb levels
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Participant_Condition
advanced esophagogastric cancer patients
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Participant_Condition
advanced or metastatic gastric/esophagogastric cancer
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Participant_Condition
Previously untreated patients were randomized
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Participant_Sample-size
118 patients enrolled