Use of darbepoetin alfa in European clinical practice for the management of chemotherapy-induced anaemia in four tumour types: Final data from the CHOICE study

Objectives: The CHOICE study was a prospective, multicentre, observational study designed to assess levels of adherence in current clinical practice to the European product label and EORTC guidelines for the treatment of chemotherapy-induced anaemia (CIA) with darbepoetin alfa (DA). Here we present data split by tumour types: breast, colorectal, ovarian and lung. Methods: Haemoglobin (Hb) levels and red blood cell transfusion requirements were evaluated among patients with solid tumours in 11 European countries. The primary outcome measure was the proportion of patients with a target Hb level of ≥10≤12g/dL. Results: The full analysis set included 1887 patients (mean±SD 62.4±11.4 years); 1585 (84) had a current disease stage of ≥3. Common chemotherapy regimens were non-platinumnon-taxane based (n=696 [37]) or platinumnon-taxane based (n=660 [35]). Breast cancer (n=575): The mean±SD Hb level at baseline was 9.9±0.8g/dL (n=568). Target Hb level was reached by 187 (55) patients. Colorectal cancer (n=310): At baseline the mean±SD Hb level was 9.8±0.8g/dL (n=306). Target Hb level was reached by 107 patients (56). Ovarian cancer (n=301): The mean±SD Hb level at baseline was 9.7±0.8g/dL (n=294). Target Hb level was reached by 81 patients (44). Lung cancer (n=701): At baseline the mean±SD Hb level was 9.8±0.9g/dL (n=692). Target Hb level was reached by 142 patients (39). Safety: Five severe or life-threatening adverse drug reactions were seen (three patients with breast cancer, one patient with colorectal cancer and one patient with ovarian cancer). Limitations: Potential bias could not be excluded due to the study's observational nature. Conclusions: This study demonstrates that the recommendations are adhered to in clinical practice, with the mean starting Hb level <10g/dL irrespective of tumour type. Furthermore, DA is likely to be effective and well tolerated for the treatment of CIA in patients with breast, colorectal, ovarian or lung cancer.

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