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Impact of ferric carboxymaltose on the evolution of hemoglobin and ECOG performance status in iron-deficient patients with solid tumors: a 3-month follow-up retrospective study

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Abstract

Background

Anemia is often associated with a lower quality of life and less tolerance to treatments in cancer patients.

Objective

The aims of this retrospective study were to assess the biological (hemoglobin, Hb) and clinical (ECOG index) impact of ferric carboxymaltose (FCM) and to identify predictive factors of response in cancer patients with iron deficiency.

Methods

We included 133 patients with solid tumors who received at least one dose of FCM in 2015.

Results

At baseline, most patients had metastatic cancer (70%), were undergoing chemotherapy (82%), suffered from anemia (90%), and 72% had an ECOG 0–1 index. Mean Hb level was statistically higher at M1 (108.3 g/L ± 13.9), M2 (110.3 g/L ± 16.1), and M3 (111.7 g/L ± 12.6) than M0 (99.2 g/L ± 13.9). Mean ECOG score increased significantly at M1 (1.31 ± 0.80) and M2 (1.31 ± 0.87) compared to M0 (1.13 ± 0.80). Variations of ECOG index between M0 and M1 were independent of levels of Hb and ferritin at inclusion and pretreatment use of transfusion and ESAs. Increase of Hb level was higher in patients with Hb < 100 g/L, ferritinemia < 800 ng/ml, or transfused before inclusion. In multivariate analysis, an ECOG index of 0 was the only predictive factor of an increase of ECOG index and Hb level < 100 g/L and ferritinemia < 800 ng/ml were predictive of an increase in Hb.

Conclusion

Even though there was no improvement in ECOG index, this study did identify an increase of Hb for patients receiving FCM, indicating its potential benefit in iron-deficient cancer patients.

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Authors and Affiliations

  1. Department of Pharmacy, Institute Sainte-Catherine, 250 Chemin de Baigne-Pieds, 84918, Avignon cedex 09, France

    J. Coussirou, C. Jean, W. Azouza, B. Chanet & F. De Crozals

  2. Department of Gastroenterology, ST Eloi Hospital, 80 Avenue Augustin Fliche, 34295, Montpellier cedex 5, France

    A. Debourdeau

  3. Department of Medical oncology, Institute Sainte-Catherine, 250 Chemin de Baigne-Pieds, 84918, Avignon cedex 09, France

    A. Stancu

  4. Department of Clinical Research, Institute Sainte-Catherine, 250 Chemin de Baigne-Pieds 18, Avignon cedex 09, France

    R. Boustany

  5. Department of Supportive Care, Institute Sainte-Catherine, 250 Chemin de Baigne-Pieds, 84918, Avignon cedex 09, France

    P. Debourdeau

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  1. J. Coussirou
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  2. A. Debourdeau
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  4. C. Jean
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Correspondence to P. Debourdeau.

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Coussirou, J., Debourdeau, A., Stancu, A. et al. Impact of ferric carboxymaltose on the evolution of hemoglobin and ECOG performance status in iron-deficient patients with solid tumors: a 3-month follow-up retrospective study. Support Care Cancer 26, 3827–3834 (2018). https://doi.org/10.1007/s00520-018-4250-x

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  • DOI: https://doi.org/10.1007/s00520-018-4250-x

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