O010 The impact of intravenous iron on physical activity levels and quality of life in advanced cancer: results from the ICARUS randomised controlled trial. (22nd July 2022)

• Record Type: Journal Article
• Authors: Dickson, EA; Ng, O; Keeler, B; Wilcock, A; Brookes, M; Acheson, AG
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 4
• Publication Date: 2022-07-22
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac242.010
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction: Anaemia and fatigue are highly prevalent in advanced cancer. Intravenous iron (IVI) has shown promise as an effective treatment for anaemia across a number of conditions. For the first time, we explore the impact of IVI on physical activity and quality of life (QoL) in advanced, inoperable cancer. Methods: We randomised anaemic, fatigued patients with advanced solid cancers to receive either IVI (iron isomaltoside) or placebo (0.9% NaCl) in a double-blind design. Activity was assessed using a pedometer (Fitbit Flex 2) for 8 days pre- infusion and at 4 and 8 weeks post-infusion. The minimum clinically important difference (MCID) was defined as 600 daily steps. Three validated QoL questionnaires were completed at the same timepoints. Results: 34 patients were recruited over 15 months (17 IVI, 17 placebo). Haemoglobin was higher with IVI at 4 weeks (MD 7.3g/L, P=0.047) and 8 weeks (MD 4.3g/L, P=0.13). At 8 weeks the mean difference in daily steps was 1707 (1142) steps (IVI +318 [1195] from baseline; placebo -1658 [2846]). On QoL measures global health (MD 15.8, P=0.027) and social functioning (MD 14.9, P=0.019) improved with IVI at 4 weeks. Fatigue scores exceeded the intergroup MCID for IVI at both follow up timepoints (week 4 MD 3.38 [-14.94–8.18], P=0.548], week 8 MD 3.49 [-17.52–10.53], P=0.609). Conclusion: IVI maintained physical activity and improved fatigue specific QoL. Placebo was associated with a significant decline activity and fatigue specific QoL. IVI may delay the functional decline experienced with advanced cancer. Take-home message: Intravenous iron led to clinically meaningful improvements in quality of life and physical activity in anaemic patients with advanced cancer.