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Erschienen in: Supportive Care in Cancer 2/2008

01.02.2008 | Original Article

The background and methodology of the Anaemia Cancer Treatment (A.C.T.) study: a global retrospective study of practice patterns and outcomes in the management of anaemia in cancer patients and their congruence with evidence-based guidelines

verfasst von: Matti Aapro, Ivo Abraham, Carsten Bokemeyer, Heinz Ludwig, Karen MacDonald, Pierre Soubeyran, Matthew Turner

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2008

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Abstract

Goal

The benefit of supportive care with erythropoiesis-stimulating agents (ESAs) for patients with cancer-related anaemia is well known. However, the European Cancer Anaemia Survey (ECAS, data from 2001) showed that about 60% of cancer patients with anaemia do not receive any treatment. Since ECAS, evidence-based guidelines have provided recommendations for ESA use, but it is not known to what extent current treatment patterns follow these guidelines. To address this issue, the Anaemia Cancer Treatment (A.C.T.) study was initiated. The background to the development of the A.C.T. study and study methodology are described.

Materials and methods

The A.C.T. study is a global, retrospective, pharmacoepidemiologic study of at least 2,560 medical records of anaemic patients with cancer who were previously treated with an ESA from a minimum of 186 centres. Records from patients aged greater than or equal to 18 years with a diagnosis of solid tumour or myeloma or lymphoma and who were started on ESAs 3–12 months before inclusion and followed for 8–10 weeks will be eligible. Factors associated with ESA non-responsiveness will also be evaluated.

Main results

Completion of the European phase of the study is anticipated in late 2007 with the rest of the world closing in late 2007 or early 2008. Publication of findings is anticipated in 2008.

Conclusions

By examining the extent to which anaemia management in clinical practice is congruent with best practice guidelines, the A.C.T. study will provide a further foundation for the development of evidence-based supportive cancer care.
Literatur
2.
Zurück zum Zitat Ahlberg K, Ekman T, Gaston-Johansson F, Mock V (2003) Assessment and management of cancer-related fatigue in adults. Lancet 362:640–650PubMedCrossRef Ahlberg K, Ekman T, Gaston-Johansson F, Mock V (2003) Assessment and management of cancer-related fatigue in adults. Lancet 362:640–650PubMedCrossRef
3.
Zurück zum Zitat Andrews NC (2004) Anemia of inflammation: the cytokine hepcidin link. J Clin Invest 113:1251–1253PubMedCrossRef Andrews NC (2004) Anemia of inflammation: the cytokine hepcidin link. J Clin Invest 113:1251–1253PubMedCrossRef
4.
Zurück zum Zitat Birgegård G, Aapro MS, Bokemeyer C et al (2005) Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology 68(Suppl 1):3–11PubMedCrossRef Birgegård G, Aapro MS, Bokemeyer C et al (2005) Cancer-related anemia: pathogenesis, prevalence and treatment. Oncology 68(Suppl 1):3–11PubMedCrossRef
5.
Zurück zum Zitat Bokemeyer C, Aapro MS, Courdi A et al (2004) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer. Eur J Cancer 40:2201–2216PubMedCrossRef Bokemeyer C, Aapro MS, Courdi A et al (2004) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer. Eur J Cancer 40:2201–2216PubMedCrossRef
6.
Zurück zum Zitat Bokemeyer C, Oechsle K, Hartmann JT (2005) Anaemia in cancer patients: pathophysiology, incidence and treatment. Eur J Clin Invest 35(Suppl 3):26–31PubMedCrossRef Bokemeyer C, Oechsle K, Hartmann JT (2005) Anaemia in cancer patients: pathophysiology, incidence and treatment. Eur J Clin Invest 35(Suppl 3):26–31PubMedCrossRef
7.
Zurück zum Zitat Bokemeyer C, Aapro MS, Courdi A et al (2007) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 43:258–270PubMedCrossRef Bokemeyer C, Aapro MS, Courdi A et al (2007) EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. Eur J Cancer 43:258–270PubMedCrossRef
8.
Zurück zum Zitat Boogaerts M, Coiffier B, Kainz C, Epoetin Beta QOL Working Group (2003) Impact of epoetin beta on quality of life in patients with malignant disease. Br J Cancer 88:988–995PubMedCrossRef Boogaerts M, Coiffier B, Kainz C, Epoetin Beta QOL Working Group (2003) Impact of epoetin beta on quality of life in patients with malignant disease. Br J Cancer 88:988–995PubMedCrossRef
9.
Zurück zum Zitat Caro JJ, Salas M, Ward A, Goss G (2001) Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 91:2214–2221PubMedCrossRef Caro JJ, Salas M, Ward A, Goss G (2001) Anemia as an independent prognostic factor for survival in patients with cancer: a systemic, quantitative review. Cancer 91:2214–2221PubMedCrossRef
10.
Zurück zum Zitat Cella D (1998) Factors influencing quality of life in cancer patients: anemia and fatigue. Semin Oncol 25(3 Suppl 7):43–46PubMed Cella D (1998) Factors influencing quality of life in cancer patients: anemia and fatigue. Semin Oncol 25(3 Suppl 7):43–46PubMed
11.
Zurück zum Zitat Curt GA, Breitbart W, Cella D et al (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 5:353–360PubMedCrossRef Curt GA, Breitbart W, Cella D et al (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 5:353–360PubMedCrossRef
12.
Zurück zum Zitat Eddy DM (2005) Evidence-based medicine: a unified approach. Health Aff (Millwood) 24:9–17CrossRef Eddy DM (2005) Evidence-based medicine: a unified approach. Health Aff (Millwood) 24:9–17CrossRef
13.
Zurück zum Zitat Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP (1999) Transfusion medicine. First of two parts—blood transfusion. N Engl J Med 340:438–447PubMedCrossRef Goodnough LT, Brecher ME, Kanter MH, AuBuchon JP (1999) Transfusion medicine. First of two parts—blood transfusion. N Engl J Med 340:438–447PubMedCrossRef
14.
Zurück zum Zitat Hedenus M, Adriansson M, San Miguel J et al; Darbepoetin Alfa 20000161 Study Group (2003) Efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies: a randomized, double-blind, placebo-controlled study. Br J Haematol 122:394–403PubMedCrossRef Hedenus M, Adriansson M, San Miguel J et al; Darbepoetin Alfa 20000161 Study Group (2003) Efficacy and safety of darbepoetin alfa in anaemic patients with lymphoproliferative malignancies: a randomized, double-blind, placebo-controlled study. Br J Haematol 122:394–403PubMedCrossRef
15.
Zurück zum Zitat Henry DH, Dahl NV, Auerbach M, Tchekmedyian S, Laufman LR; Ferrlecit Cancer Study Group (2004) Intravenous ferric gluconate (FG) for increasing response to epoetin (EPO) in patients with anemia of cancer chemotherapy—results of a multicenter, randomized trial. Blood 104:3696 (abstract) Henry DH, Dahl NV, Auerbach M, Tchekmedyian S, Laufman LR; Ferrlecit Cancer Study Group (2004) Intravenous ferric gluconate (FG) for increasing response to epoetin (EPO) in patients with anemia of cancer chemotherapy—results of a multicenter, randomized trial. Blood 104:3696 (abstract)
16.
Zurück zum Zitat Jackson R, Feder G (1998) Guidelines for clinical guidelines. BMJ 317:427–428PubMed Jackson R, Feder G (1998) Guidelines for clinical guidelines. BMJ 317:427–428PubMed
17.
Zurück zum Zitat Kreft I, De Leeuw J (1998) Introducing multilevel modeling. Sage Publications, London Kreft I, De Leeuw J (1998) Introducing multilevel modeling. Sage Publications, London
18.
Zurück zum Zitat Littlewood TJ, Bajetta E, Nortier JWR, Vercammen E, Rapoport B; Epoetin Alfa Study Group (2001) Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 19:2865–2874PubMed Littlewood TJ, Bajetta E, Nortier JWR, Vercammen E, Rapoport B; Epoetin Alfa Study Group (2001) Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol 19:2865–2874PubMed
19.
Zurück zum Zitat Locatelli F, Aljama P, Bárány P et al; European Best Practice Guidelines Working Group (2004) Revised European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant 19(Suppl 2):ii1–ii47 Locatelli F, Aljama P, Bárány P et al; European Best Practice Guidelines Working Group (2004) Revised European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant 19(Suppl 2):ii1–ii47
20.
Zurück zum Zitat Ludwig H, Fritz E, Kotzmann H et al (1990) Erythropoietin treatment of anemia associated with multiple myeloma. N Engl J Med 322:1693–1699PubMedCrossRef Ludwig H, Fritz E, Kotzmann H et al (1990) Erythropoietin treatment of anemia associated with multiple myeloma. N Engl J Med 322:1693–1699PubMedCrossRef
21.
Zurück zum Zitat Ludwig H, Van Belle S, Barrett-Lee P et al (2004) The European Cancer Anaemia Study (ECAS): a large, multinational, prospective study defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer 40:2293–2306PubMedCrossRef Ludwig H, Van Belle S, Barrett-Lee P et al (2004) The European Cancer Anaemia Study (ECAS): a large, multinational, prospective study defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer 40:2293–2306PubMedCrossRef
22.
Zurück zum Zitat Österborg A (1998) Recombinant human erythropoietin (rHuEPO) therapy in patients with cancer-related anaemia: what have we learned. Med Oncol 15(Suppl 1):S47–S49PubMed Österborg A (1998) Recombinant human erythropoietin (rHuEPO) therapy in patients with cancer-related anaemia: what have we learned. Med Oncol 15(Suppl 1):S47–S49PubMed
23.
Zurück zum Zitat Österborg A, Brandberg Y, Molostova V et al; Epoetin Beta Hematology Study Group (2002) Randomized, double-blind, placebo-controlled trial of recombinant human erythropoietin, epoetin beta, in hematologic malignancies. J Clin Oncol 20:2486–2494PubMedCrossRef Österborg A, Brandberg Y, Molostova V et al; Epoetin Beta Hematology Study Group (2002) Randomized, double-blind, placebo-controlled trial of recombinant human erythropoietin, epoetin beta, in hematologic malignancies. J Clin Oncol 20:2486–2494PubMedCrossRef
24.
Zurück zum Zitat Rizzo JD, Lichtin AE, Woolf SH et al; American Society of Clinical Oncology. American Society of Hematology (2002) Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. J Clin Oncol 20:4083–4107PubMedCrossRef Rizzo JD, Lichtin AE, Woolf SH et al; American Society of Clinical Oncology. American Society of Hematology (2002) Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. J Clin Oncol 20:4083–4107PubMedCrossRef
25.
Zurück zum Zitat Rosser WW, Davis D, Gilbart E (2001) Assessing guidelines for use in family practice. J Fam Pract 50:969–973PubMed Rosser WW, Davis D, Gilbart E (2001) Assessing guidelines for use in family practice. J Fam Pract 50:969–973PubMed
26.
Zurück zum Zitat Sandler SG, Yu H, Rassai N (2003) Risks of blood transfusion and their prevention. Clin Adv Hematol Oncol 1:307–313PubMed Sandler SG, Yu H, Rassai N (2003) Risks of blood transfusion and their prevention. Clin Adv Hematol Oncol 1:307–313PubMed
27.
Zurück zum Zitat Spaeth D, Casadevall N, Daouphars M et al; Standards, Options and Recommendations project (2004) Summary version of the standards, options and recommendations for the use of recombinant erythropoietin (epoietin-alpha and beta, darbepoietin-alpha, EPO) in the management of anaemia in oncology—update 2003. Bull Cancer 91(2):179–188PubMed Spaeth D, Casadevall N, Daouphars M et al; Standards, Options and Recommendations project (2004) Summary version of the standards, options and recommendations for the use of recombinant erythropoietin (epoietin-alpha and beta, darbepoietin-alpha, EPO) in the management of anaemia in oncology—update 2003. Bull Cancer 91(2):179–188PubMed
28.
Zurück zum Zitat Thomas ML (1998) Impact of anemia and fatigue on quality of life in cancer patients: a brief review. Med Oncol 15(Suppl 1):S3–S7PubMed Thomas ML (1998) Impact of anemia and fatigue on quality of life in cancer patients: a brief review. Med Oncol 15(Suppl 1):S3–S7PubMed
29.
Zurück zum Zitat Timmermans S, Mauck A (2005) The promises and pitfalls of evidence-based medicine. Health Aff (Millwood) 24:18–28CrossRef Timmermans S, Mauck A (2005) The promises and pitfalls of evidence-based medicine. Health Aff (Millwood) 24:18–28CrossRef
30.
Zurück zum Zitat Turner R, Anglin P, Burkes R et al; Canadian Cancer and Anemia Guidelines Development Group (2001) Epoetin alfa in cancer patients: evidence-based guidelines. J Pain Symptom Manage 22(5):954–965PubMedCrossRef Turner R, Anglin P, Burkes R et al; Canadian Cancer and Anemia Guidelines Development Group (2001) Epoetin alfa in cancer patients: evidence-based guidelines. J Pain Symptom Manage 22(5):954–965PubMedCrossRef
31.
Zurück zum Zitat Van Belle S, Paridaens R, Evers G et al (2005) Comparison of proposed diagnostic criteria with FACT-F and VAS for cancer-related fatigue: proposal for use as a screening tool. Support Care Cancer 13:246–254PubMedCrossRef Van Belle S, Paridaens R, Evers G et al (2005) Comparison of proposed diagnostic criteria with FACT-F and VAS for cancer-related fatigue: proposal for use as a screening tool. Support Care Cancer 13:246–254PubMedCrossRef
32.
Zurück zum Zitat Vogelzang NJ, Breitbart W, Cella D et al (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment study. The Fatigue Coalition. Semin Hematol 34(3 Suppl 2):4–12PubMed Vogelzang NJ, Breitbart W, Cella D et al (1997) Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment study. The Fatigue Coalition. Semin Hematol 34(3 Suppl 2):4–12PubMed
Metadaten
Titel
The background and methodology of the Anaemia Cancer Treatment (A.C.T.) study: a global retrospective study of practice patterns and outcomes in the management of anaemia in cancer patients and their congruence with evidence-based guidelines
verfasst von
Matti Aapro
Ivo Abraham
Carsten Bokemeyer
Heinz Ludwig
Karen MacDonald
Pierre Soubeyran
Matthew Turner
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
Supportive Care in Cancer / Ausgabe 2/2008
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-007-0311-2

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