Darbapoetin Alfa In Chemotherapy Induced Anaemia: Check out 5 takeaways from recent study

Darbepoetin alfa significantly reduces the reliance on blood transfusions while boosting hemoglobin levels in cancer patients experiencing chemotherapy-induced anemia, a recent Indian study has reported.

A recent real-world retrospective study published in Frontiers in Oncology was conducted at Narayana Super-specialty Hospital-Howrah, a tertiary care center in Kolkata, India; enrolled 523 patients with advanced or metastatic solid tumors undergoing palliative myelosuppressive therapy over a six-year period.

The study analyzed electronic health records to evaluate the impact of darbepoetin alfa (Cresp®, 200 mcg subcutaneous injection by Dr Reddy’s Laboratories, administered biweekly) on chemotherapy-induced anemia. The study included adults (≥18 years) with advanced or metastatic solid tumors who had completed at least two cycles of palliative myelosuppressive chemotherapy. Eligible patients had an Hb level of ≤10.0 g/dL at diagnosis, though those with Hb levels between 10.0 and 11.0 g/dL were included if symptomatic for anemia. Enrollment required at least one dose of darbepoetin alfa. The study excluded pediatric patients, those with early-stage solid tumors receiving curative treatment, individuals with hematological malignancies, patients on targeted therapy alone or with non-myelosuppressive agents, and those previously exposed to recombinant erythropoietin.

The primary endpoint of the study was to measure the change in hemoglobin levels from baseline to post-treatment. Secondary endpoints included the reduction in blood transfusion dependence, improvements in patient-reported anemia symptoms such as fatigue and dyspnea, and the occurrence of treatment-emergent adverse events (TEAEs) such as hypertension, deep vein thrombosis (DVT), and arrhythmias.

The median age of the cohort was 55 years, and patients were divided based on cancer type, chemotherapy regimen, treatment response, and administered doses of darbepoetin alfa.

Key findings of the study include:

Significant Hemoglobin Improvement: Patients exhibited a marked increase in mean hemoglobin levels from a baseline of 8.56 ± 0.45 g/dL to 10.84 ± 0.92 g/dL resulting in a statistically significant 2.28 g/dL rise (P<.001). The benefit of darbepoetin alfa was observed consistently across all analyzed subgroups, including different cancer types (gastrointestinal, head and neck, lung, breast, genitourinary, gynecological malignancies, and others), chemotherapy types (single-agent and combination regimens), chemotherapy protocols (taxane + platinum, gemcitabine + platinum, fluoropyrimidine-based, single-agent taxane, platinum monotherapy, and others). Figure 1.

Change in Hemoglobin in Relation to Cancer Therapy Response: A subgroup analysis revealed that patients demonstrating a partial response to cancer therapy experienced the highest hemoglobin increment (2.66 ± 0.51 g/dL), compared to those with stable disease (1.86 ± 0.82 g/dL) or progressive disease (1.40 ± 0.59 g/dL). Furthermore, patients receiving more than four doses of Darbepoetin alfa showed a superior hemoglobin improvement compared to those administered only four or fewer doses.

Reduction in Blood Transfusion Dependence: At baseline, 50 patients (9.6%) required blood transfusion. Following darbepoetin alfa administration, only 22 patients continued to need transfusions, corresponding to a risk reduction of 56%.

Improvement in Anemia-Related Symptoms: Patient-reported outcomes highlighted significant alleviation in symptoms such as fatigue and dyspnea (P<.001 for both), indicating the quality-of-life benefits linked to improved hemoglobin levels after darbepoetin alfa treatment.

Favorable Tolerability Profile: Adverse events were relatively infrequent. Hypertension (5.4%), deep vein thrombosis (2.9%), and arrhythmias (0.8%) were the most commonly observed treatment-emergent adverse events.

Given the risks of frequent blood transfusions, such as thromboembolic events and immune complications in palliative cancer care, this study demonstrated that erythropoiesis-stimulating agents (ESAs) like Darbepoetin alfa play a critical role in managing chemotherapy-induced anemia (CIA).

Figure: Mean increment in hemoglobin (Hb) levels across subgroups from baseline to end of treatment. Statistically significant (P<.001) increment in mean Hb levels was recorded across all subgroups.

This study highlighted the efficacy and tolerability of Darbepoetin alfa (Cresp® by Dr Reddy’s Laboratories) in addressing chemotherapy-induced anemia (CIA) in Indian real-world settings. Darbepoetin alfa increased hemoglobin levels, reduced the need for blood transfusions, and improved the quality of life among cancer patients undergoing chemotherapy.

GGI-CO-A1-AQS-300021457-NB-C25-1139

Reference: Chandrakanth M, Agarwala V, Sopory P, Nayak H, Parikh PM, Roy M, De R, Narayan P, Barai AT, Mandal K, Basu M, Kumar S,Uppal RS, Naqvi SMH and Desai R (2025) Cresp®: transforming the landscape of chemotherapy-induced anemia - a comprehensive retrospective real-world analysis in 523 Indian patients.Front. Oncol. 15:1418327.doi: 10.3389/fonc.2025.1418327