{"title":"Effect of erythropoiesis-stimulating agents on malignant neoplasms: FAERS database and mendelian randomization.","authors":"Cuilv Liang, Qiaohong Wang, Peihong Wang, Yin Zhang","doi":"10.1080/17474086.2025.2468400","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The relationship between erythropoiesis-stimulating agents (ESAs) and malignant neoplasms (MNs) has been controversial in previous studies. Our study aimed to explore the correlation between ESAs and MNs.</p><p><strong>Research design and methods: </strong>Drug-target Mendelian randomization (MR) analyses were conducted to evaluate the causal associations of ESAs for 12 classifications of MNs. Meanwhile, a pharmacovigilance study was performed by extracting adverse events (AEs) in the FDA Adverse Event Reporting System (FAERS) database to validate and complement our findings. MR analysis revealed negative association of ESAs with MN of ovary (<i>p</i> = 0.047), liposarcoma(<i>p</i> = 0.001), small cell lung cancer(<i>p</i> = 0.017), colorectal cancer(<i>p</i> = 0.004), brain meningioma(<i>p</i> = 0.004), and revealed positive association of ESAs with MN of bladder (<i>p</i> = 0.001), eye and adnexa (<i>p</i> = 0.012), heart, mediastinum and pleura (<i>p</i> = 0.032), lip (<i>p</i> = 0.041), larynx (<i>p</i> = 0.015)，non small cell lung cancer (<i>p</i> = 0.009), malignant melanoma (<i>p</i> = 0.001). Positive signals were found in MN of hematological system, digestive organs, central nervous system, eye and adnexa, head and neck cancer, lung cancer, mucinous and mucinous cystic tumor in FAERS database (all reporting odds ratio (ROR) and proportional reporting ratio (PRR) >1).</p><p><strong>Conclusion: </strong>ESAs were causally correlated with many types of MNs. More attention needs to be paid to the use of ESAs in these tumors.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17474086.2025.2468400","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
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Abstract
Background: The relationship between erythropoiesis-stimulating agents (ESAs) and malignant neoplasms (MNs) has been controversial in previous studies. Our study aimed to explore the correlation between ESAs and MNs.
Research design and methods: Drug-target Mendelian randomization (MR) analyses were conducted to evaluate the causal associations of ESAs for 12 classifications of MNs. Meanwhile, a pharmacovigilance study was performed by extracting adverse events (AEs) in the FDA Adverse Event Reporting System (FAERS) database to validate and complement our findings. MR analysis revealed negative association of ESAs with MN of ovary (p = 0.047), liposarcoma(p = 0.001), small cell lung cancer(p = 0.017), colorectal cancer(p = 0.004), brain meningioma(p = 0.004), and revealed positive association of ESAs with MN of bladder (p = 0.001), eye and adnexa (p = 0.012), heart, mediastinum and pleura (p = 0.032), lip (p = 0.041), larynx (p = 0.015)，non small cell lung cancer (p = 0.009), malignant melanoma (p = 0.001). Positive signals were found in MN of hematological system, digestive organs, central nervous system, eye and adnexa, head and neck cancer, lung cancer, mucinous and mucinous cystic tumor in FAERS database (all reporting odds ratio (ROR) and proportional reporting ratio (PRR) >1).
Conclusion: ESAs were causally correlated with many types of MNs. More attention needs to be paid to the use of ESAs in these tumors.
期刊介绍：
Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.
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