1615P - The impact of anemia in advanced solid tumors treated with sorafenib (SO) and sunitinib (SU): a pooled analysis of 6 trials

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive Measures
Presenter Sandro Barni
Authors S. Barni1, K.F. Borgonovo2, M. Ghilardi3, M. Cabiddu4, F. Maspero4, M. Cremonesi4, F. Petrelli5
  • 1Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 2Oncologia Medica E Chemioterapia, Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 3Medical Oncology Division, A.O. Trevilgio-Caravaggio, 24047 - Treviglio/IT
  • 4Medical Oncology Division, Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 5Uo Oncologia, Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT



Anemia is a frequent and serious complication experienced by many cancer patients, especially those receiving chemotherapy. Targeted therapies are associated with a significant risk of anemia too but this data is often underreported in clinical trials. We described in a published meta-analysis of 24.310 patients affected by solid tumours, that the addition of targeted therapies to standard treatment increased by 7% the risk of all grades anemia (p = 0.09). Now we perform a pooled analysis to evaluate the risk of anemia in patients treated with So and Su as single agent therapy

Materials and methods

We searched PubMed for published, randomized, controlled, Phase II and III trials (RCTs), and we have performed a pooled-analysis to calculate the incidence of anemia associated with So and Su. Relative risk (RR) with 95% confidence interval has been calculated to quantify the burden of anemia in these patients.


Six studies have been selected, for a total of 2802 patients analysed. Four trials included Su and 2 So. Comparison arms were: Axitinib in 1 trial, Bevacizumab/INF or Bevacizumab/Temsirolimus in 1 trial, placebo in 3 trials and no therapy in 1 trial The overall incidence of anemia was 44% in experimental vs 34% in control arms (incidence difference 9.8%; p = <0.0001). The RR was 1.19 (p = 0.02). The risk is significant only for low grade anemia (G 1-2: incidence 42%) with RR = 1.19 (p < 0.0001). A meta-regression was performed to calculate the weight of median treatment duration on anemia risk and the results is significant (p = 0.00046).


The treatment with Sunitinib and Sorafenib increases by about 20% compared with control arms the risk of anemia, and it increases the longer is the duration of treatment. We think that this information is particular useful in kidney cancer patients which often are affected by anemia subsequent kidney surgery. Because of the potential deleterious effects of anemia on patients' quality of life, performance score, and therapeutic outcomes, the treatment of anemia is an important component in the overall care of cancer patients.


All authors have declared no conflicts of interest.