Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Apr;84(Suppl 1):11–16. doi: 10.1054/bjoc.2001.1747

Pharmacokinetics of novel erythropoiesis stimulating protein (NESP) in cancer patients: preliminary report

A C Heatherington 1, J Schuller 2, A J Mercer 3
PMCID: PMC2363902  PMID: 11308269

Abstract

Anaemia is a common occurrence in patients with cancer, and currently can be treated in several ways. Novel erythropoiesis stimulating protein (NESP, darbepoetin alfa) was created using site-directed mutagenesis to have 8 more sialic acid side chains than recombinant human erythropoietin (rHuEPO). The additional sialic acid content has resulted in an approximately 3-fold greater half-life relative to rHuEPO in patients with chronic renal failure. This study evaluates the pharmacokinetic profile of NESP in patients receiving multiple cycles of chemotherapy. Anaemic patients (haemoglobin ≤ 11.0 g dl−1) who had non-myeloid malignancies received NESP weekly (2.25 mcg kg−1 wk−1) under the supervision of a physician, starting on day 1 of chemotherapy for 3 chemotherapy cycles given at 3-week intervals. Blood samples were collected during chemotherapy cycles 1 and 3 for pharmacokinetic analysis. All patients were followed for 4 weeks after treatment. NESP was well tolerated by all patients. After a single dose during chemotherapy cycle 1, pharmacokinetic parameters (mean (SD), n) for the first 15 patients were: T max 86.1 (22.8) h (n = 14); C max 9.0 (5.1) ng ml−1(n = 14); t 1/2,z 32.6 (11.8) h (n = 7); CL/F 3.7 (1.0) ml h−1 kg−1(n = 7). The subjects for whom all parameters could be calculated may represent a sub-group of the entire population. Similar results were obtained in cycle 3. In addition, haemoglobin response data suggests that, in this patient population, dosing less frequently than the 3 times weekly doses used for rHuEPO may be possible while improving anaemia. © 2001 Cance Cancer Research Campaign

Keywords: cancer, chemotherapy, clinical study, darbepoetin alfa, pharmacokinetics

Full Text

The Full Text of this article is available as a PDF (127.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cascinu S., Fedeli A., Del Ferro E., Luzi Fedeli S., Catalano G. Recombinant human erythropoietin treatment in cisplatin-associated anemia: a randomized, double-blind trial with placebo. J Clin Oncol. 1994 May;12(5):1058–1062. doi: 10.1200/JCO.1994.12.5.1058. [DOI] [PubMed] [Google Scholar]
  2. Del Mastro L., Venturini M., Lionetto R., Garrone O., Melioli G., Pasquetti W., Sertoli M. R., Bertelli G., Canavese G., Costantini M. Randomized phase III trial evaluating the role of erythropoietin in the prevention of chemotherapy-induced anemia. J Clin Oncol. 1997 Jul;15(7):2715–2721. doi: 10.1200/JCO.1997.15.7.2715. [DOI] [PubMed] [Google Scholar]
  3. Glaspy J., Bukowski R., Steinberg D., Taylor C., Tchekmedyian S., Vadhan-Raj S. Impact of therapy with epoetin alfa on clinical outcomes in patients with nonmyeloid malignancies during cancer chemotherapy in community oncology practice. Procrit Study Group. J Clin Oncol. 1997 Mar;15(3):1218–1234. doi: 10.1200/JCO.1997.15.3.1218. [DOI] [PubMed] [Google Scholar]
  4. Glaspy J., Jadeja J. S., Justice G., Kessler J., Richards D., Schwartzberg L., Rigas J., Kuter D., Harmon D., Prow D. A dose-finding and safety study of novel erythropoiesis stimulating protein (NESP) for the treatment of anaemia in patients receiving multicycle chemotherapy. Br J Cancer. 2001 Apr;84 (Suppl 1):17–23. doi: 10.1054/bjoc.2001.1748. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Henry D. H., Abels R. I. Recombinant human erythropoietin in the treatment of cancer and chemotherapy-induced anemia: results of double-blind and open-label follow-up studies. Semin Oncol. 1994 Apr;21(2 Suppl 3):21–28. [PubMed] [Google Scholar]
  6. Henry D. H. Epoetin alfa and high-dose chemotherapy. Semin Oncol. 1998 Jun;25(3 Suppl 7):54–57. [PubMed] [Google Scholar]
  7. Ludwig H., Sundal E., Pecherstorfer M., Leitgeb C., Bauernhofer T., Beinhauer A., Samonigg H., Kappeler A. W., Fritz E. Recombinant human erythropoietin for the correction of cancer associated anemia with and without concomitant cytotoxic chemotherapy. Cancer. 1995 Dec 1;76(11):2319–2329. doi: 10.1002/1097-0142(19951201)76:11<2319::aid-cncr2820761121>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  8. Macdougall I. C., Gray S. J., Elston O., Breen C., Jenkins B., Browne J., Egrie J. Pharmacokinetics of novel erythropoiesis stimulating protein compared with epoetin alfa in dialysis patients. J Am Soc Nephrol. 1999 Nov;10(11):2392–2395. doi: 10.1681/ASN.V10112392. [DOI] [PubMed] [Google Scholar]
  9. Macdougall I. C. Novel erythropoiesis stimulating protein. Semin Nephrol. 2000 Jul;20(4):375–381. [PubMed] [Google Scholar]
  10. Macdougall I. C., Roberts D. E., Neubert P., Dharmasena A. D., Coles G. A., Williams J. D. Pharmacokinetics of recombinant human erythropoietin in patients on continuous ambulatory peritoneal dialysis. Lancet. 1989 Feb 25;1(8635):425–427. doi: 10.1016/s0140-6736(89)90014-7. [DOI] [PubMed] [Google Scholar]
  11. Maraveyas A., Pettengell R. What is the role of erythropoietin in patients with solid tumours? Ann Oncol. 1998 Mar;9(3):239–241. doi: 10.1023/a:1008273032715. [DOI] [PubMed] [Google Scholar]
  12. Miller C. B., Platanias L. C., Mills S. R., Zahurak M. L., Ratain M. J., Ettinger D. S., Jones R. J. Phase I-II trial of erythropoietin in the treatment of cisplatin-associated anemia. J Natl Cancer Inst. 1992 Jan 15;84(2):98–103. doi: 10.1093/jnci/84.2.98. [DOI] [PubMed] [Google Scholar]
  13. Piroso E., Erslev A. J., Caro J. Inappropriate increase in erythropoietin titers during chemotherapy. Am J Hematol. 1989 Dec;32(4):248–254. doi: 10.1002/ajh.2830320403. [DOI] [PubMed] [Google Scholar]
  14. Platanias L. C., Miller C. B., Mick R., Hart R. D., Ozer H., McEvilly J. M., Jones R. J., Ratain M. J. Treatment of chemotherapy-induced anemia with recombinant human erythropoietin in cancer patients. J Clin Oncol. 1991 Nov;9(11):2021–2026. doi: 10.1200/JCO.1991.9.11.2021. [DOI] [PubMed] [Google Scholar]
  15. Sawabe Y., Kikuno K., Iseki T., Lida S., Tabata Y., Yonemitsu H. Changes in serum erythropoietin and the reticulocyte count during chemotherapy for leukemias. Eur J Haematol. 1996 Nov;57(5):384–388. doi: 10.1111/j.1600-0609.1996.tb01397.x. [DOI] [PubMed] [Google Scholar]
  16. Spivak J. L., Hogans B. B. The in vivo metabolism of recombinant human erythropoietin in the rat. Blood. 1989 Jan;73(1):90–99. [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES