Iron Supplementation during Treatment with Erythropoiesis-Stimulating Agents for Cancer-Related Anemia

Unresponsiveness to erythropoiesis-stimulating agents is a major limitation to the treatment of chemotherapy-related anemia. This is often related to a disregulation of iron metabolism leading to functional iron deficiency. However, the use of iron supplementation during treatment with erythropoiesis-stimulating agents has not been as rigorously pursued in anemic patients with cancer as it has in chronic kidney disease. In this article, we review and discuss the role of iron supplementation in the setting of chemotherapy-related anemia in view of recently published clinical trials addressing this issue.

[1]  T. Littlewood,et al.  The use of intravenous iron in patients with cancer‐related anaemia , 2008, British journal of haematology.

[2]  T. Pintér,et al.  Randomized, multicenter, controlled trial comparing the efficacy and safety of darbepoetin alpha administered every 3 weeks with or without intravenous iron in patients with chemotherapy-induced anemia. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  R. Labianca,et al.  Randomized trial of intravenous iron supplementation in patients with chemotherapy-related anemia without iron deficiency treated with darbepoetin alpha. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  M. Auerbach Should intravenous iron be the standard of care in oncology? , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  M. Somerfield,et al.  Use of epoetin and darbepoetin in patients with cancer: 2007 American Society of Clinical Oncology/American Society of Hematology clinical practice guideline update. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  G. Birgegard,et al.  Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study , 2008, Leukemia.

[7]  J. Glaspy,et al.  Clinical update: intravenous iron for anaemia , 2007, The Lancet.

[8]  G. Birgegard,et al.  Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies: a randomized multicenter study , 2007, Leukemia.

[9]  N. Dahl,et al.  Intravenous ferric gluconate significantly improves response to epoetin alfa versus oral iron or no iron in anemic patients with cancer receiving chemotherapy. , 2007, The oncologist.

[10]  C. Bokemeyer,et al.  EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update. , 2007, European journal of cancer.

[11]  G. Schwarzer,et al.  Recombinant human erythropoietins and cancer patients: updated meta-analysis of 57 studies including 9353 patients. , 2006, Journal of the National Cancer Institute.

[12]  G. Chertow,et al.  Update on adverse drug events associated with parenteral iron. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[13]  R. B. M. Frcgp Anaemia in cancer patients , 2005 .

[14]  Y. Beguin Erythropoietic agents and iron , 2005 .

[15]  N. Andrews Anemia of inflammation: the cytokine-hepcidin link. , 2004, The Journal of clinical investigation.

[16]  M. Auerbach,et al.  Intravenous iron optimizes the response to recombinant human erythropoietin in cancer patients with chemotherapy-related anemia: a multicenter, open-label, randomized trial. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  D. Cella,et al.  Control of cancer-related anemia with erythropoietic agents: a review of evidence for improved quality of life and clinical outcomes. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[18]  S. Woolf,et al.  Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. , 2002, Blood.

[19]  M. Fiegl,et al.  Double-blind, placebo-controlled, randomized phase III trial of darbepoetin alfa in lung cancer patients receiving chemotherapy. , 2002, Journal of the National Cancer Institute.

[20]  Y. Beguin Prediction of response and other improvements on the limitations of recombinant human erythropoietin therapy in anemic cancer patients. , 2002, Haematologica.

[21]  A. Besarab,et al.  Optimization of epoetin therapy with intravenous iron therapy in hemodialysis patients. , 2000, Journal of the American Society of Nephrology : JASN.

[22]  Henry,et al.  Supplemental Iron: A Key to Optimizing the Response of Cancer-Related Anemia to rHuEPO? , 1998, The oncologist.

[23]  I. Macdougall,et al.  A randomized controlled study of iron supplementation in patients treated with erythropoietin. , 1996, Kidney international.