Erythropoietin in Cancer: Presumption of Innocence?
Article first published online: 26 APR 2007
Copyright © 2007 AlphaMed Press
Volume 25, Issue 8, pages 2094–2097, August 2007
How to Cite
Blau, C. A. (2007), Erythropoietin in Cancer: Presumption of Innocence?. STEM CELLS, 25: 2094–2097. doi: 10.1634/stemcells.2007-0229
- Issue published online: 2 JAN 2009
- Article first published online: 26 APR 2007
- Manuscript Accepted: 24 APR 2007
- Manuscript Received: 28 MAR 2007
Erythropoietin emerged as the biggest drug in oncology despite never having demonstrated a survival benefit in patients with cancer. Two phase III clinical trials reported more than 3 years ago that erythropoietin adversely affected cancer survival rates, due mainly to tumor progression. Despite changes to the product label for erythropoietins in 2004, clinical practice remained unchanged until recent weeks when, following reports of three new phase III studies and a phase II trial, a “black box warning” for erythropoietin products was issued by the Food and Drug Administration (FDA). Whether erythropoietin products can be considered safe when used for FDA-approved indications is currently at issue; however, addressing this question will be difficult until the mechanisms of erythropoietin-stimulated tumor progression are understood. A thorough evaluation of materials from clinical trials already completed may shed new light on how erythropoietin promotes cancer progression. Until these issues are resolved, oncologists should inform their patients of erythropoietin's potential adverse impact on cancer progression and survival.
Disclosure of potential conflicts of interest is found at the end of this article.