Patients with solid tumors commonly develop iron deficiency (ID). Iron supplementation was found to improve quality of life (QOL) and functional capacity for these patients, according to study results published in the journal The Oncologist.
In the prospective, single-center CAMARA study (ClinicalTrials.gov Identifier: NCT03625661), researchers analyzed the effect of iron supplementation on QOL in patients with solid tumors. Participants were patients aged 18 and older, undergoing treatment for a solid tumor at the researchers’ facility, and had a diagnosis of iron deficiency with a transferrin saturation coefficient of <20% and a ferritin level of either <800 ng/mL (reflecting functional ID) or <300 ng/mL (reflecting absolute ID).
Patients received intravenous ferric carboxymaltose as iron supplementation. QOL was evaluated using the Functional Assessment of Cancer Therapy-Anemia (FACT-An) scale, and the primary endpoint was changes in this measure at an intermediate visit occurring 15 to 30 days after iron supplementation. Secondary endpoints were changes in this measure across a series of time points: at baseline, at the intermediate visit, and at 6 months. Functional performance also was accessed through the Tinetti test (gait and balance in older adults), the Berg balance scale, the 6 minute walk test, the timed up and go test, and the number of sit/stand actions in 1 minute.
A total of 186 evaluable patients were included in the analysis. At baseline, absolute ID was present in 140 patients (75.7%). Anemia was detected in 141 of 174 patients (81.0%). At the final visit, 43 of 106 evaluated patients (40.6%) continued to have anemia.
In the primary endpoint analysis, FACT-An scores showed significant improvements at the intermediate visit, from a median score of 116.2 initially to a median score of 124.9 at the intermediate visit (P <.001). In analyses of secondary endpoints, FACT-An scores for the patients who completed all 3 visits also significantly improved across time points from baseline through the final measurement at 6 months (P <.001).
The dimensions associated with significant levels of improvement across the 3 time points were related to physical well-being (P <.001), the anemia-specific scale (P <.001), emotional well-being (P =.015), and functional well-being (P =.021). Scores related to physical well-being, emotional well-being, and the anemia-specific scale were also significantly better by the intermediate visit, relative to baseline values.
In analyses of functional performance, improvements were seen across the full study period in the timed up and go test (P <.001), the number of actions in the sit/stand test (P =.001), and the 6-minute walk test (P =.003). The 2 other function assessments did not show improvements over the study period (the Tinetti test [P =.081] and the Berg test [P =.084]).
“For the first time, we prospectively demonstrated that iron supplementation was significantly associated with increased QOL in oncology patients with [iron deficiency], in the short and long term,” the study investigators stated.
Gluszak C, de Vries-Brilland M, Seegers V, et al. Impact of iron-deficiency management on quality of life in patients with cancer: a prospective cohort study (CAMARA Study). Oncologist. Published on March 4, 2022. doi:10.1093/oncolo/oyac005