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TRANSLATIONAL AND CLINICAL RESEARCH

Erythropoietin in Cancer: Presumption of Innocence?

Department of Medicine/Hematology, Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, Washington, USA

Correspondence: C. Anthony Blau, M.D., Mailstop 357710, K260 Health Sciences Building, Department of Medicine/Hematology, Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, Washington 98195, USA Telephone: 206-685-6873; Fax: 206-543-3560; e-mail: tblau{at}u.washington.edu

Received on March 28, 2007; accepted for publication on April 24, 2007.

First published online in STEM CELLS EXPRESS  April 26, 2007.


Erythropoietin emerged as the biggest drug in oncology despite never having demonstrated a survival benefit in patients with cancer. Two phase III clinical trials reported more than 3 years ago that erythropoietin adversely affected cancer survival rates, due mainly to tumor progression. Despite changes to the product label for erythropoietins in 2004, clinical practice remained unchanged until recent weeks when, following reports of three new phase III studies and a phase II trial, a "black box warning" for erythropoietin products was issued by the Food and Drug Administration (FDA). Whether erythropoietin products can be considered safe when used for FDA-approved indications is currently at issue; however, addressing this question will be difficult until the mechanisms of erythropoietin-stimulated tumor progression are understood. A thorough evaluation of materials from clinical trials already completed may shed new light on how erythropoietin promotes cancer progression. Until these issues are resolved, oncologists should inform their patients of erythropoietin's potential adverse impact on cancer progression and survival.

Disclosure of potential conflicts of interest is found at the end of this article.

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