REPLY
Renal Cell Carcinoma and Erythropoietin
Jonathan Rubins, MD
1 November 1995 | Volume 123 Issue 9 | Page 733
IN RESPONSE:
As Dr. Sungur states, there are substantial differences between the clinical features of his patient and mine. My patient had a complete remission of bulky tumor in apparent response to exogenous erythropoietin [1]. Even if the patients were similar, however, differences in response would not be surprising. In tumors with well-established hormone sensitivity, such as breast cancer, only some patients respond to hormone therapy, even among women with a favorable estrogen receptor profile. Another possible explanation for variation in response is a difference in dosage. Dr. Sungur's patient first received a maximum dose of 12 000 U/wk for 6 weeks and then 4000 U/wk. My patient received 150 U/kg body weight three times per week (approximately three times the dose received by Dr. Sungur's patient) until remission was established and has received 2000 U every 2 weeks for more than 1 year.
My patient received Procrit (Ortho Biotech, Raritan, New Jersey). My colleagues and I have just begun a pilot study testing this product in patients with locally recurrent or metastatic renal cell carcinoma. Even one response in the first 10 patients would be strong evidence that our initial patient's response was causally related to the administration of erythropoietin.
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Author and Article Information
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F.F. Thompson Hospital; Canandaigua, NY 14424
1. Rubins J. Metastatic renal cell carcinoma: response to treatment with human recombinant erythropoeitin. Ann Intern Med. 1995; 122:676-7.
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