Erythropoiesis-stimulating agents in gynecological malignancies: A study-level meta-analysis

This meta-analysis was planned to define the role of erythropoiesis-stimulating agents (ESAs) in gynecological cancer patients, receiving myelosuppressive treatment. Pubmed, Medline and Scopus were searched to select English-language articles. Only randomized controlled trials (RCTs) were included. Endpoints were incidence of transfusions, thrombotic events (TE), deaths, and failures. Odd ratio (OR) with 95% confidence interval (CI) was calculated using fixed or random effects model. In seven RCTs ESAs studies of 892 patients under treatment, use of ESAs correlates with a significant reduction of transfusions rate (OR = 0.35; 95% CI: 0.19-0.65; p = 0.008). OR for overall mortality was 1.10 (95% CI 0.82-1.49; p = 0.53). ESAs OR for disease failure in 5 studies was 1.71 (95% CI: 0.90-3.24; p = 0.1). This meta-analysis, even if limited by few RCTs, suggests that ESAs reduce transfusions without increasing mortality or disease progression in gynecological cancer patients receiving treatment. (C) 2015 Elsevier Ireland Ltd. All rights reserved.