BMJ  2007;334:1297 (23 June), doi:10.1136/bmj.334.7607.1297

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FDA considers curbing use of erythropoietins for patients with cancer

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The controversy surrounding overuse of synthetic erythropoietins in the US has shifted lately to patients with cancer, who are given these agents for the anaemia associated with chemotherapyGo. While treatment helps patients avoid blood transfusions, the potential risks include thromboembolism (already seen in patients with chronic renal failure) and the stimulation of tumour growth, which could lead to shorter survival. The evidence of harm is patchy but worrying according to three recent comment articles, and the US Food and Drug Administration (FDA) is gearing up to place further restrictions on synthetic erythropoietins for patients with breast cancer, small cell lung cancer, and some head and neck cancers. Data from clinical trials suggest treatment with synthetic erythropoietins can reduce survival in patients with these cancers, although the principal manufacturers disagree, and few good data are available to resolve the argument. Product labels already have a "black box" warning that urges . . . [Full text of this article]


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