Experimental Drugs for Chemotherapy- and Cancer-Related Anemia

Abstract

Anemia in cancer patients is a relevant condition complicating the course of the neoplastic disease. Overall, we distinguish the anemia which arises under chemotherapy as pure adverse event of the toxic effects of the drugs used, and the anemia induced by the tumour-associated inflammation, oxidative stress, and systemic metabolic changes, which can be worsened by the concomitant anticancer treatments. This more properly cancer-related anemia depends on several overlapping mechanism, including impaired erythropoiesis and functional iron deficiency, which make its treatment more difficult. Standard therapies approved and recommended for cancer anemia, as erythropoiesis-stimulating agents and intravenous iron administration, are limited to the treatment of chemotherapy-induced anemia, preferably in patients with advanced disease, in view of the still unclear effect of erythropoiesis-stimulating agents on tumour progression and survival. Outside the use of chemotherapy, there are no recommendations for the treatment of cancer-related anemia. For a more complete approach, it is fundamentally a careful evaluation of the type of anemia and iron homeostasis, markers of inflammation and changes in energy metabolism. In this way, anemia management in cancer patient would permit a tailored approach that could give major benefits. Experimental drugs targeting hepcidin and activin II receptor pathways are raising great expectations, and future clinical trials will confirm their role as remedies for cancer-related anemia. Recent evidence on the effect of integrated managements, including nutritional support, antioxidants and anti-inflammatory substances, for the treatment of cancer anemia are emerging. In this review article, we show standard, innovative, and experimental treatment used as remedy for anemia in cancer patients.

Protective Effect of Kaempferol and Its Nanoparticles on 5-Fluorouracil-Induced Cardiotoxicity in Rats

“…Anemia is one of the most usual side effects of chemotherapy drugs, and continuous administration of single-agent 5-FU can cause about 50% of first- and second-degree anemias [ 39 , 40 ].…”

Factors for the development of anemia in patients with newly introduced olaparib: A retrospective case-control study

“…[6] In clinical practice, cancer-related anemia can be caused by several overlapping mechanisms (e.g., impaired erythropoiesis and chemotherapy-induced loss of appetite). [7][8][9] For a more complete approach, careful evaluation of cancer-related anemia is important.…”

Anemia can predict prognosis and response to neoadjuvant chemotherapy in osteosarcoma at pre-operative stage: a retrospective analysis

“…Regarding to anemia recti cation, blood transfusion, erythropoietin-stimulating agents (ESAs) and iron are three main treatment modalities [32]. Since blood transfusion become more restrictive in mild or moderate anemia after the induction of ESAs, results of clinical trials support the e cacy and safety of ESAs in cancer patients.…”

“…It has several deleterious effects in patients suffered from malignancy. Several studies have reported a negative impact of anemia on disease progression, response to chemo-/radiotherapy, survival, and risk of death [19,20]. Although anemia may be a consequence of more aggressive forms of cancer, which have worse outcomes, the additional mechanisms unrelated to the tumor may affect prognosis in patients with anemia.…”