Clinical experience with ferric carboxymaltose in the treatment of cancer- and chemotherapy-associated anaemia.
BACKGROUND
Intravenous (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.


METHODS
Of 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.


RESULTS
The 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.


CONCLUSIONS
The 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.
Outpatient Clinic for Oncology and Haematology, Cologne. Electronic address: steinmetz@oncokoeln.de.
T
T
Steinmetz
Klinikum Neustadt am Rübenberge, Neustadt am Rübenberge.
B
B
Tschechne
Vifor Pharma, Munich, Germany.
O
O
Harlin
Vifor Pharma, Glattbrugg, Switzerland.
B
B
Klement
iOMEDICO AG.
M
M
Franzem
Oncology Practice, Osnabrueck.
J
J
Wamhoff
Outpatient Clinic, Im Pruefling, Frankfurt.
H
H
Tesch
Oncology Outpatient Clinic, Halle/Saale.
R
R
Rohrberg
Practice for Oncology and Hematology, Freiburg, German.
N
N
Marschner
D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000139:chemically induced* / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D008320:Maltose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D005290:Ferric Compounds; D006397:Hematinics; D006454:Hemoglobins; C522335:ferric carboxymaltose; D008320:Maltose; D005293:Ferritins