Red blood cell (RBC) transfusion should be the preferred approach for the management of anemia in women with hemoglobin ≤ 11.0 g/dL receiving first- or second-line chemotherapy for metastatic breast cancer. This according to a study of 2,098 women with metastatic breast cancer who were randomly assigned to receive either EPO 40,000 IU subcutaneously once a week or best standard of care. Researchers found:

• Median progression-free survival (PFS) was 7.4 months in both groups.

• Median overall survival at clinical cutoff was 17.2 months in the EPO group and 17.4 months in the best standard of care group.

• Median time to tumor progression in both groups was 7.5 months.

• Overall response rate was 50% in the EPO group and 51% in the best standard of care group.

• RBC transfusions were 5.8% vs 11.4% and thrombotic vascular events were 2.8% vs 1.4 in the EPO and best standard of care groups, respectively.

Citation: Leyland-Jones B, Bondarenko I, Nemsadze G, et al. A randomized, open-label, multicenter, phase III study of epoetin alfa versus best standard of care in anemic patients with metastatic breast cancer receiving standard chemotherapy. [Published online ahead of print February 8, 2016]. Clin Oncol. doi:10.1200/JCO.2015.63.5649.