Modeling of treatment response to erythropoiesis-stimulating agents as a function of center- and patient-related variables: Results from the Anemia Cancer Treatment (ACT) study

M. Aapro, H. Ludwig, C. Bokemeyer, K. MacDonald, P. Soubeyran, M. Turner, T. Albrecht, Ivo L Abraham

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: In anemic cancer patients treated with erythropoiesis-stimulating agent (ESA), (i) to examine the proportion of variance in hemoglobin (Hb) outcomes attributable to patients versus center, country, and region and (ii) to develop predictive models of treatment response. Methods: Retrospective study with a minimum of three visits at 1-month intervals. Three hundred and seven centers in 13 European countries contributed 2192 anemic ESA-treated cancer patients. Treatment response criteria included: Hb↑≥1 g/dl, Hb↑≥1 g/dl within 8 weeks, hematopoietic response (Hb↑≥2 g/dl or Hb ≥ 12 g/dl), Hb↑≥2 g/dl, and Hb between 12 and 13 g/dl. Results: Hb increased from 9.54 ± 0.95 g/dl (baseline) to 10.88 ± 1.49 g/dl (visit 3). Hb change from visits 1 to 2 (index of relative immediacy of response to ESA) averaged 0.81 ± 1.17 g/dl. The proportion of variance in Hb outcomes attributable to center was 11.8%-34.3%, country 2.9%-20.7%, and region 0.0%-7.6%. Immediacy of response to ESA was the most prevalent predictor of treatment response, followed by diagnosis of hematological malignancy and age <70 years. Conclusions: Hb outcomes are determined significantly by the treating center and less so by country or region. The remaining majority variance was attributable to patient-related factors. Immediacy of response to ESA is the single most important predictor of treatment. When used according to guidelines, ESAs are effective in managing anemia in cancer patients and improving treatment outcomes.

Original languageEnglish (US)
Pages (from-to)1714-1721
Number of pages8
JournalAnnals of Oncology
Volume20
Issue number10
DOIs
StatePublished - 2009

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Hematinics
Anemia
Hemoglobins
Neoplasms
Therapeutics
Hematologic Neoplasms
Retrospective Studies
Guidelines

Keywords

  • Anemia
  • Erythropoietin
  • Hemoglobin
  • Modeling
  • Outcomes
  • Treatment response

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Modeling of treatment response to erythropoiesis-stimulating agents as a function of center- and patient-related variables : Results from the Anemia Cancer Treatment (ACT) study. / Aapro, M.; Ludwig, H.; Bokemeyer, C.; MacDonald, K.; Soubeyran, P.; Turner, M.; Albrecht, T.; Abraham, Ivo L.

In: Annals of Oncology, Vol. 20, No. 10, 2009, p. 1714-1721.

Research output: Contribution to journalArticle

Aapro, M. ; Ludwig, H. ; Bokemeyer, C. ; MacDonald, K. ; Soubeyran, P. ; Turner, M. ; Albrecht, T. ; Abraham, Ivo L. / Modeling of treatment response to erythropoiesis-stimulating agents as a function of center- and patient-related variables : Results from the Anemia Cancer Treatment (ACT) study. In: Annals of Oncology. 2009 ; Vol. 20, No. 10. pp. 1714-1721.
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abstract = "Background: In anemic cancer patients treated with erythropoiesis-stimulating agent (ESA), (i) to examine the proportion of variance in hemoglobin (Hb) outcomes attributable to patients versus center, country, and region and (ii) to develop predictive models of treatment response. Methods: Retrospective study with a minimum of three visits at 1-month intervals. Three hundred and seven centers in 13 European countries contributed 2192 anemic ESA-treated cancer patients. Treatment response criteria included: Hb↑≥1 g/dl, Hb↑≥1 g/dl within 8 weeks, hematopoietic response (Hb↑≥2 g/dl or Hb ≥ 12 g/dl), Hb↑≥2 g/dl, and Hb between 12 and 13 g/dl. Results: Hb increased from 9.54 ± 0.95 g/dl (baseline) to 10.88 ± 1.49 g/dl (visit 3). Hb change from visits 1 to 2 (index of relative immediacy of response to ESA) averaged 0.81 ± 1.17 g/dl. The proportion of variance in Hb outcomes attributable to center was 11.8{\%}-34.3{\%}, country 2.9{\%}-20.7{\%}, and region 0.0{\%}-7.6{\%}. Immediacy of response to ESA was the most prevalent predictor of treatment response, followed by diagnosis of hematological malignancy and age <70 years. Conclusions: Hb outcomes are determined significantly by the treating center and less so by country or region. The remaining majority variance was attributable to patient-related factors. Immediacy of response to ESA is the single most important predictor of treatment. When used according to guidelines, ESAs are effective in managing anemia in cancer patients and improving treatment outcomes.",
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T1 - Modeling of treatment response to erythropoiesis-stimulating agents as a function of center- and patient-related variables

T2 - Results from the Anemia Cancer Treatment (ACT) study

AU - Aapro, M.

AU - Ludwig, H.

AU - Bokemeyer, C.

AU - MacDonald, K.

AU - Soubeyran, P.

AU - Turner, M.

AU - Albrecht, T.

AU - Abraham, Ivo L

PY - 2009

Y1 - 2009

N2 - Background: In anemic cancer patients treated with erythropoiesis-stimulating agent (ESA), (i) to examine the proportion of variance in hemoglobin (Hb) outcomes attributable to patients versus center, country, and region and (ii) to develop predictive models of treatment response. Methods: Retrospective study with a minimum of three visits at 1-month intervals. Three hundred and seven centers in 13 European countries contributed 2192 anemic ESA-treated cancer patients. Treatment response criteria included: Hb↑≥1 g/dl, Hb↑≥1 g/dl within 8 weeks, hematopoietic response (Hb↑≥2 g/dl or Hb ≥ 12 g/dl), Hb↑≥2 g/dl, and Hb between 12 and 13 g/dl. Results: Hb increased from 9.54 ± 0.95 g/dl (baseline) to 10.88 ± 1.49 g/dl (visit 3). Hb change from visits 1 to 2 (index of relative immediacy of response to ESA) averaged 0.81 ± 1.17 g/dl. The proportion of variance in Hb outcomes attributable to center was 11.8%-34.3%, country 2.9%-20.7%, and region 0.0%-7.6%. Immediacy of response to ESA was the most prevalent predictor of treatment response, followed by diagnosis of hematological malignancy and age <70 years. Conclusions: Hb outcomes are determined significantly by the treating center and less so by country or region. The remaining majority variance was attributable to patient-related factors. Immediacy of response to ESA is the single most important predictor of treatment. When used according to guidelines, ESAs are effective in managing anemia in cancer patients and improving treatment outcomes.

AB - Background: In anemic cancer patients treated with erythropoiesis-stimulating agent (ESA), (i) to examine the proportion of variance in hemoglobin (Hb) outcomes attributable to patients versus center, country, and region and (ii) to develop predictive models of treatment response. Methods: Retrospective study with a minimum of three visits at 1-month intervals. Three hundred and seven centers in 13 European countries contributed 2192 anemic ESA-treated cancer patients. Treatment response criteria included: Hb↑≥1 g/dl, Hb↑≥1 g/dl within 8 weeks, hematopoietic response (Hb↑≥2 g/dl or Hb ≥ 12 g/dl), Hb↑≥2 g/dl, and Hb between 12 and 13 g/dl. Results: Hb increased from 9.54 ± 0.95 g/dl (baseline) to 10.88 ± 1.49 g/dl (visit 3). Hb change from visits 1 to 2 (index of relative immediacy of response to ESA) averaged 0.81 ± 1.17 g/dl. The proportion of variance in Hb outcomes attributable to center was 11.8%-34.3%, country 2.9%-20.7%, and region 0.0%-7.6%. Immediacy of response to ESA was the most prevalent predictor of treatment response, followed by diagnosis of hematological malignancy and age <70 years. Conclusions: Hb outcomes are determined significantly by the treating center and less so by country or region. The remaining majority variance was attributable to patient-related factors. Immediacy of response to ESA is the single most important predictor of treatment. When used according to guidelines, ESAs are effective in managing anemia in cancer patients and improving treatment outcomes.

KW - Anemia

KW - Erythropoietin

KW - Hemoglobin

KW - Modeling

KW - Outcomes

KW - Treatment response

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DO - 10.1093/annonc/mdp063

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