Clinical and economic benefits of parenteral iron carboxymaltosate in patients with gynecological cancers: A retrospective observational study

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Abstract

Background. Timely diagnosis and treatment of iron deficiency anemia in cancer patients affect the quality of life and the effectiveness of anti-tumor treatment. However, choosing a method for correcting anemia is imperative to achieve maximum efficiency and safety with the least financial costs.

Aim. To evaluate postoperative methods for treating iron deficiency anemia in patients with gynecological cancers based on a comparative analysis of the clinical and economic outcomes of intravenous iron carboxymaltosate and blood transfusions.

Materials and methods. A study of 125 cases of malignant neoplasms of the female reproductive system with a history of iron deficiency anemia was conducted. Study Group 1 included 85 patients with malignancies receiving 500–1000 mg of iron carboxymaltosate (ICM) intravenously; Group 2 included 40 patients with transfusion of packed red cells (PRC). Clinical and economic outcomes of methods for anemia treatment were analyzed.

Results. In Group 1, the maximum increase in hemoglobin level was observed from Week 2 of ICM treatment (median increase 1.3 g/dL) peaking by Week 9–10 (median increase 2.3 g/dL). In Group 2 the maximum increase in hemoglobin level was noted at Week 1 after PRC transfusion (median increase 2.1 g/dL), with a gradually decreasing hemoglobin level for 3 weeks after that. No side effects of ICM treatment were reported. In 7 (17.5%) patients, a pyrogenic reaction (hyperthermia) was reported after a blood transfusion. The median time from surgery to the beginning of anti-tumor treatment (radiation therapy, chemotherapy) in Group 1 was 19 days [17; 25] vs. 26 days [22; 30] in Group 2 (p=0.0021).

Conclusion. High-dose ICM therapy for iron deficiency anemia in patients with gynecological malignancies is cost-effective and shows a long-term clinical effect.

About the authors

Valeriya V. Saevets

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine; South Ural State Medical University

Author for correspondence.
Email: lalili2013@mail.ru
ORCID iD: 0000-0003-2572-2408

cand. sci. (med.)

Russian Federation, Chelyabinsk

Anna Yu. Shamanova

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: anna-sha@bk.ru
ORCID iD: 0000-0002-9280-0608

cand. sci. (med.)

Russian Federation, Chelyabinsk

References

  1. Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia. Eds. B. de Benoist, E. McLean, I. Egli, M. Cogswell.
  2. Knight K, Wade S, Balducci L. Prevalence and outcome of anemia in cancer: a systematic review of the literature. Am J Med. 2004;116(7):11-26. doi: 10.1016/j.amjmed.2003.12.008
  3. Schrijvers D, De Samblanx H, Roila F. Erythropoiesis-stimulating agents in the treatment of anaemia in cancer patients: ESMO Clinical Practice Guidelines for use. Ann Oncol. 2010;21:v244-7. doi: 10.1093/annonc/mdq202
  4. Ludwig H, Van Belle S, Barrett-Lee P, et al. The European Cancer Anaemia Survey (ECAS): A large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. Eur J Cancer. 2004;40(15):2293-306. doi: 10.1016/j.ejca.2004.06.019
  5. Ludwig H, Müldür E, Endler G, et al. Prevalence of iron deficiency across different tumors and its association with poor performance status, disease status and anemia. Ann Oncol. 2013;24:1886-92. doi: 10.1093/annonc/mdt118
  6. Henry D, Dahl N, Auerbach M, et al. Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. Oncologist. 2007;12:231-42. doi: 10.1634/theoncologist.12-2-231
  7. Bastit L, Vandebroek A, Altintas S, et al. Randomized, multicenter, controlled trial comparing the efficacy and safety of darbepoetin alfa administered every 3 weeks with or without intravenous iron in patients with chemotherapy-induced anemia. J Clin Oncol. 2008;26:1611-8. doi: 10.1200/JCO.2006.10.4620
  8. Abdel-Razeq H, Abbasi S, Saadi I, et al. Intravenous iron monotherapy for the treatment of non-iron-deficiency anemia in cancer patients undergoing chemotherapy: a pilot study. Drug Des Devel Ther. 2013;30(7):939-44. doi: 10.2147/DDDT.S45674
  9. Moore RA, Gaskell H, Rose P, et al. Meta-analysis of efficacy and safety ofintravenous ferric carboxymaltose (Ferinject) fromclinical trial reports and published trial data. BMC Blood Disorders. 2011;11:4. doi: 10.1186/1471-2326-11-4
  10. Саевец В.В., Алексеева А.П., Таратонов А.В., и др. Анализ экономической эффективности терапии железодефицитной анемии у пациентов со злокачественными новообразованиями. Уральский медицинский журнал. 2021;20(2):59-63 [Saevets VV, Alekseeva АР, Taratonov АV, et al. Analysis of economic efficiency of iron deficiency anemia therapy in patients with malignant tumors. Ural Medical Journal. 2021;20(2):59-63 (in Russian)]. doi: 10.52420/2071-5943-2021-20-2-59-63
  11. Crawford J, Cella D, Cleeland C, et al. Relationship between changes in hemoglobin level and quality of life during chemotherapy in anemic cancer patients receiving epoetin alfa therapy. Cancer. 2002;95:888-95. doi: 10.1002/cncr.10763
  12. Тhomas G. The effect of hemoglobin level on radiotherapy outcomes: the Canadian experience. Semin Oncol. 2001;28:60-5. doi: 10.1016/s0093-7754(01)90215-5
  13. Орлова Р.В., Гладков О.А., Жуков Н.В. Практические рекомендации по лечению анемии при злокачественных новообразованиях. Практические рекомендации RUSSCO. 2020;10(3s2):32-8 [Orlova RV, Gladkov OA, Zhukov NV. Prakticheskiie rekomendatsii po lecheniiu anemii pri zlokachestvennykh novoobrazovaniiakh. Prakticheskiie rekomendatsii RUSSCO. 2020;10(3s2):32-8 (in Russian)].
  14. Connor J, O’Shea A, McCool K, et al. Peri-operative allogeneic blood transfusion is associated with poor overall survival in advanced epithelial ovarian cancer; potential impact of patient blood management on cancer outcomes. Gynecol Oncol. 2018;151:294-8. doi: 10.1016/j.ygyno.2018.08.040
  15. Steinmetz T, Tschechne B, Harlin O, et al. Clinical experience with ferric carboxymaltose in the treatment of cancer- and chemotherapy-associated anaemia. Ann Oncol. 2013;24(2):475-82. doi: 10.1093/annonc/mds338
  16. Abdel-Razeq H, Saadeh SS, Malhis R, et al. Treatment of anemia in cancer patients undergoing chemotherapy with intravenous ferric carboxymaltose without erythropoiesis-stimulating agents. Ther Adv Med Oncol. 2020;12:1758835920953292. doi: 10.1177/1758835920953292
  17. Gordon D, Nichols G, Ben-Jacob A, et al. Treating anemia of cancer with every-4-week darbepoetin alfa: final efficacy and safety results from a phase II, randomized, double-blind, placebo-controlled study. Oncologist. 2008;13:715-24. doi: 10.1634/theoncologist.2007-0241
  18. Littlewood T, Bajetta E, Nortier J, et al. Effects of epoetin alfa on hematologic parameters and quality of life in cancer patients receiving nonplatinum chemotherapy: results of a randomized, double-blind, placebo-controlled trial. J Clin Oncol. 2001;19:2865-74. doi: 10.1200/JCO.2001.19.11.2865
  19. Shander A, Corwin HL, Meier J, et al. Recommendations From the International Consensus Conference on Anemia Management in Surgical Patients (ICCAMS). Ann Surg. 277(4):581-90. doi: 10.1097/SLA.0000000000005721

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2. Fig. 1. Comparative histogram of the hemoglobin increase (g/dL) in patients of the study groups (Groups 1 and 2) over time (weeks) after the ICM therapy and blood transfusions.

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