Standards of proof, standards of practice, and proof of standards: a tale of two trials. Clinical Oncology

摘要

In this issue of the Journal of Clinical Oncology, Chang et al and Witzig et al report two randomized controlled trials evaluating the role of recombinant human erythropoietin (epoetin alfa) for the management of anemia in cancer patients receiving chemotherapy. Previous rigorous trials and systematic reviews of randomized trials have demonstrated the efficacy of this agent in maintaining hemoglobin levels and reducing transfusion requirements in cancer patients receiving chemotherapy.3"5 Recommendations from high-quality, evidence-based clinical practice guidelines confirm the role for epoetin alfa in anemia management in this clinical setting.4'5 The drug is already commonly used in practice. Furthermore, the public and patients welcome the availability of a therapeutic option that can reduce exposure to what they perceive as the risks of blood transfusion.