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Poster Display session 1

712 - The use of intravenous ferric carboxymaltose without erythropoiesis-stimulating agents in the treatment of anemia in cancer patients undergoing chemotherapy with or without radiotherapy

Date

28 Sep 2019

Session

Poster Display session 1

Topics

Supportive Care and Symptom Management

Tumour Site

Presenters

Hikmat Abdel-Razeq

Citation

Annals of Oncology (2019) 30 (suppl_5): v718-v746. 10.1093/annonc/mdz265

Authors

H. Abdel-Razeq, S.S. Saadeh, R. Malhis, O. AL-Natour, S. Yaser, H. Abdulelah, R. Eljaber, G. Khalaf

Author affiliations

  • Internal Medicine, King Hussein Cancer Center KHCC, 11195 - Amman/JO

Resources

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Abstract 712

Background

Anemia in cancer patients undergoing chemotherapy is commonly encountered and may worsen their quality of life. Because of recent concerns about their negative effect on overall survival and serious adverse events, erythropoiesis-stimulating agents (ESA) are not commonly prescribed. This study will assess the efficacy and safety of intravenous ferric carboxymaltose (FCM) therapy in such patients.

Methods

Adult patients with non-myeloid malignancies on chemotherapy with Hemoglobin (Hb)≤ 11.0 g/dL and a life expectancy >24 weeks were recruited. Based on serum ferritin (sFr) level and transferrin saturation (TSAT), patients were categorized into three Groups: Group-I (Absolute Iron Deficiency: AIDA) with sFr <30 ng/mL and TSAT <20%. Group-II (Functional Iron Deficiency Anemia: FIDA) with sFr 30-800 ng/mL and TSAT <20%. Patients with TSAT >20% were placed in group-III as “others”. Based on Hb level and body weight, patients were given FCM in one or two short intravenous infusions.

Results

A total of 84 patients; 70 (83.3%) females were recruited. Median age [standard deviation] was 53.8 [10.6] years. Chemotherapy varied according to the primary cancer and many had it as a second-line or beyond. The median Hb level at baseline was 10.2 (range: 8.3-11.0 ) gm/dL. At week-12, patients with AIDA (26,31.0%) and FIDA (24, 28.6%) had a significant increment in Hb (median increment: 2.35 and 1.5 gm/dL, respectively). Patients in Group-III (34, 40.5%) had limited response. Most of the increment (≥1.0 g/dL) occurred as early as week-3. No immediate infusion-related adverse events were reported. However, asymptomatic hypophosphatemia was observed in 39 (46.4%) patients (table).Table:

1814P

VariablesAbsolute iron deficiency (n = 26)Functional iron deficiency (n = 24)Others (n = 34)P-value
Ferritin Level (week 12, mg/mL) Mean (SD) Median (range)589 (509) 442 (177-2794)838 (875) 577 (168-4184)956 (667) 802 (166-2687)0.0247
Phophorus level (week 2, mg/dL) Mean (SD) Median (range)1.8 (0.7) 1.5 (1.1-3.4)2.5 (1.0) 3.3 (1.0-5.4)2.2 (0.9) 3.3 (1.0-4.1)0.0124
Hypophophatemia Number Percentage17 65.4%6 25.0%16 47.1%

Conclusions

Intravenous FCM, without ESA, is safe and effective in the treatment of anemia in cancer patients undergoing active treatment with chemotherapy.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

King Hussein Cancer Center.

Disclosure

All authors have declared no conflicts of interest.

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