Standards of care for anemia management in oncology: focus on lung carcinoma

Cancer. 2002 Aug 1;95(3):613-23. doi: 10.1002/cncr.10712.


Background: Anemia is common in patients with lung carcinoma, particularly among those undergoing platinum-based cytotoxic chemotherapy. Evidence is growing that anemia can have a profound impact on the patient's quality of life, often manifested as the patient's inability to function normally.

Methods: A literature review was conducted to provide a current picture of the incidence and impact of anemia in patients with lung carcinoma and the usage and limitations of current treatment.

Results: The incidence of anemia (a hemoglobin [Hb] level < 11g/dL) in lung carcinoma patients is approximately 50-60%, varying according to treatment regimen. However, despite evidence supporting the treatment of anemia, many clinicians only intervene when Hb levels fall below 8 g/dL. This may be because of a lack of awareness of the incidence and impact of anemia on cancer patients, but most likely is because of limitations of current treatment options (blood transfusion and recombinant human erythropoietin [epoetin-alpha]). Darbepoetin-alpha represents a new generation of erythropoiesis-stimulating proteins. Biochemically distinct from epoetin-alpha, darbepoetin-alpha has a greater sialic acid content and biologic half-life than epoetin-alpha, but stimulates erythropoiesis in the same manner. Clinical trials involving patients with cancer-related anemia have shown that darbepoetin-alpha has a threefold longer half-life than epoetin-alpha, which may allow less frequent dosing. The results from an ongoing clinical trial dedicated to testing the clinical benefits of darbepoetin-alpha in treating anemia in lung carcinoma patients will provide a valuable insight into its full potential in this setting.

Conclusions: Anemia is common but is reported to be undertreated in patients with lung carcinoma. The introduction of darbepoetin-alpha into clinical practice may overcome some of the limitations of current treatments and facilitate improvement in the management of cancer-related anemia.

Publication types

  • Review

MeSH terms

  • Anemia / chemically induced
  • Anemia / complications
  • Anemia / therapy*
  • Blood Transfusion / statistics & numerical data
  • Darbepoetin alfa
  • Erythropoietin / analogs & derivatives
  • Erythropoietin / therapeutic use
  • Hemoglobins / metabolism
  • Humans
  • Lung Neoplasms / blood
  • Lung Neoplasms / complications
  • Lung Neoplasms / drug therapy*
  • Platinum Compounds / adverse effects
  • Quality of Life


  • Hemoglobins
  • Platinum Compounds
  • Erythropoietin
  • Darbepoetin alfa