Feasibility of Intravenous Iron Isomaltoside to Improve Anemia and Quality of Life During Palliative Chemotherapy for Esophagogastric Adenocarcinoma
Mené sur 27 patients atteints d'un adénocarcinome œsogastrique et souffrant d'anémie, cet essai randomisé évalue l'effet, sur les changements du taux de ferritine et sur l'amélioration de la qualité de vie, d'une dose de fer isomaltoside dispensée par voie intraveineuse, avant une chimiothérapie
Background: Anemia is common with esophagogastric adenocarcinoma, increasing mortality, blood transfusions, and reducing quality of life (QOL). No clear evidence exists for safe and effective treatment. Methods: Anemic patients (Hb <12?g/dl women, <13?g/dl men) with esophagogastric adenocarcinoma were recruited before initiation of palliative chemotherapy. Patients were randomized to standard care or single dose of intravenous iron isomaltoside (IVI) before chemotherapy. Post-chemotherapy changes in hemoglobin (Hb), ferritin, transferrin saturations (TSAT), blood transfusions, and QOL were recorded for three cycles of chemotherapy. Results: Twenty-seven patients were randomized to standard care (n?=?13) or IVI (n?=?14). No significant change in Hb was seen (standard care MD ?0.6?g/dl 95% CI ?0.1?1.1?g/dl, P?=?0.336; IVI MD +0.5?g/dl 95% CI ?0.1?1.1?g/dl, P?=?0.903). An increase in ferritin was seen with IVI after cycle one of chemotherapy (standard care 116?ng/ml; IVI 770?ng/ml, P?<?0.05). No difference in blood transfusions was seen between groups (P?=?0.851). IVI improved QOL with physical well-being, emotional well-being, anemia-specific QOL, trial outcome index, and total scores all exceeding minimum clinically important difference. No improvement was seen with standard care. Conclusions: This feasibility study suggests IVI improves quality of life and ferritin. Larger adequately powered studies are required to definitively conclude if hemoglobin and blood transfusion changes with IVI.
Nutrition and Cancer 2018