Assessing adherence to the European Organization for Research and Treatment of Cancer (EORTC) guidelines for the use of erythropoiesis-stimulating agents in cancer patients

Abstract

20696 Background: Anemia is a common symptom in cancer patients and has a considerable impact on patient quality of life (QoL). According to the European Cancer Anemia Survey, anemia was treated in only 38.9% of patients. Erythropoiesis-stimulating agents (ESAs) are widely used for the treatment of the chemotherapy-induced anemia (CIA). The European Organization for Research and Treatment of Cancer (EORTC) recently published guidelines for the use of ESAs in cancer patients, but actual adherence to these guidelines in clinical practice is unknown. Methods: Between March and July 2007, 16 working sessions were held and 179 Spanish oncologists were consulted to assess their adherence to the EORTC guidelines (update 2006)for the use of ESAs. In all sessions, a preliminary presentation about these guidelines was given, followed by a structured discussion that was facilitated by a moderator using an organized, brain storming work method (Metaplan). Results: Over 90% of oncologists agreed that the two major goals of ESA therapy are improvement of QoL and prevention of transfusions; 70% consider that CIA treatment with ESA should be initiated at a hemoglobin (Hb) level of 10–11g/dL. ESAs are administered every week (59%) or every three weeks (33%). In the opinion of 64% of respondents, the target Hb concentration should be 12–13 g/dL. Altogether 45% of oncologists use ESA in anemic patients with an Hb level of <11.9 g/dL to prevent a further decline in Hb. All participants agreed with the use of fixed doses of ESAs. Intravenous iron supplementation is low (5%). Conclusions: These study results show good adherence to the current EORTC guidelines in Spain, but action to increase adherence may improve patient outcomes. The main discrepancies are the use of intravenous iron and ESA in patients with Hb <11.9 g/dL. This study was supported by Amgen S.A. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Amgen Amgen