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NCCN Updates Cancer- and Treatment-Related Anemia Guidelines

FORT WASHINGTON, Pa., December 20, 2007 — The National Comprehensive Cancer Network (NCCN) announces important updates to the NCCN Cancer- and Treatment-Related Anemia Guidelines relating to the use of erythropoietin-stimulating agents (ESAs), such as epoetin alfa and darbepoetin alfa.

ESAs are no longer recommended for the treatment of cancer-related anemia associated with solid tumors or hematologic malignancies other than myelodysplastic syndromes (MDS). ESA therapy is an option for patients receiving myelosuppressive chemotherapy who have symptoms of anemia and hemoglobin levels of less than 11 g/dL. ESA therapy should only be considered as an option for patients receiving myelosuppressive chemotherapy without symptoms of anemia if they have hemoglobin levels less than or equal to 10 g/dL and additional risk factors for the development of symptomatic anemia requiring transfusion. When ESAs are administered to patients with cancer receiving myelosuppressive chemotherapy, the drug dosage should be titrated to achieve hemoglobin levels in the range of 10 to <12 g/dL for the purpose of avoiding red blood cell transfusion. Use of ESAs in patients with cancer receiving myelosuppressive chemotherapy is limited to the period during chemotherapy and for a short period following chemotherapy, usually within 6 weeks following the end of such therapy. These changes reflect recent evidence indicating decreased survival in patients with cancer receiving ESA therapy and changes made to the product labels of these agents by the Food and Drug Administration (FDA).

In order to facilitate shared physician-patient decision-making for those patients with cancer at risk of anemia requiring transfusion who will undergo myelosuppressive chemotherapy, patient counseling regarding the risks and benefits of ESA therapy is recommended.

NCCN Clinical Practice Guidelines in Oncology™ are developed and updated through an evidence-based process with explicit review of the scientific evidence by multidisciplinary panels of expert physicians from NCCN Member Institutions. The most recent version of this and all the guidelines are available free of charge at www.nccn.org.