From what I recall, there was a trial which showed that patients (can't remember which type of cancer) receiving ESAs had a higher rate of recurrence. This probably prompted the meta-analysis you are referring to. But even before that, there was preclinical data suggesting that ESAs have off-target effects that could affect progression. I'm not aware that this is the case with the TPO agonists, but I wonder whether the ESA controversy is preventing oncologists from using TPO agonists off-label.
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