Clinical experience with ferric carboxymaltose in the treatment of cancer- and chemotherapy-associated anaemia

Abstract

BackgroundIntravenous (i.v.) iron can improve anaemia of chronic disease and response to erythropoiesis-stimulating agents (ESAs), but data on its use in practice and without ESAs are limited. This study evaluated effectiveness and tolerability of ferric carboxymaltose (FCM) in routine treatment of anaemic cancer patients.Patients and methodsOf 639 patients enrolled in 68 haematology/oncology practices in Germany, 619 received FCM at the oncologist's discretion, 420 had eligible baseline haemoglobin (Hb) measurements, and 364 at least one follow-up Hb measurement. Data of transfused patients were censored from analysis before transfusion.ResultsThe median total iron dose was 1000 mg per patient (interquartile range 600–1500 mg). The median Hb increase was comparable in patients receiving FCM alone (1.4 g/dl [0.2–2.3 g/dl; N = 233]) or FCM + ESA (1.6 g/dl [0.7–2.4 g/dl; N = 46]). Patients with baseline Hb up to 11.0 g/dl and serum ferritin up to 500 ng/ml benefited from FCM treatment (stable Hb ≥11.0 g/dl). Also patients with ferritin >500 ng/ml but low transferrin saturation benefited from FCM treatment. FCM was well tolerated, 2.3% of patients reported putative drug-related adverse events.ConclusionsThe substantial Hb increase and stabilisation at 11–12 g/dl in FCM-treated patients suggest a role for i.v. iron alone in anaemia correction in cancer patients.

Impact of a Patient Blood Management Program and an Outpatient Anemia Management Protocol on Red Cell Transfusions in Oncology Inpatients and Outpatients

“…Although we could not prove causality, reason exists to believe that IV iron can help maintain or even increase hemoglobin in patients with CAA or CIA [18]. Steinmetz et al [19] studied patients enrolled in 68 hematology/ oncology practices in Germany who were treated with ferric They found a hemoglobin increase and stabilization at a hemoglobin of 11-12 g/dL in FCM-treated patients. The second and third strategies involved adopting even more restrictive transfusion thresholds and greater use of single-unit transfusion.…”

The Effectiveness of Ferric Carboxymaltose on the Improvement of Chronic Iron Deficiency Anemia in Patients With Colon Cancer: A Controlled Randomized Clinical Trial

“…Steinmetz et al (17) in Germany used ferric carboxymaltose to treat iron deficiency anemia caused by cancer or chemotherapy. Also in the current study, changes in hemoglobin and ferritin levels were investigated to evaluate the efficacy of ferric carboxymaltose treatment.…”

Iron sucrose – characteristics, efficacy and regulatory aspects of an established treatment of iron deficiency and iron-deficiency anemia in a broad range of therapeutic areas

“…Otherwise, the use of IS without additional ESA treatment could also benefit at least some patients in terms of improved Hb levels and reduction of RBC transfusions as suggested by early studies in patients with gynecological cancers who received chemotherapy [64,65] and a prospective observational study in patients with cancer-and chemotherapy-associated anemia [66].…”