ICaRAS - IV Iron for Cancer Related Anaemia Symptoms
Research type
Research Study
Full title
ICaRAS (IV Iron for Cancer Related Anaemia Symptoms) – A Feasibility Study of Intravenous Iron Therapy for Anaemia in Palliative Cancer Care.
IRAS ID
246403
Contact name
Austin Acheson
Contact email
Sponsor organisation
Nottingham University Hospitals NHS Trust
Eudract number
2018-001669-17
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Fatigue is the most common symptom in palliative cancer care patients occurring in up to 80% of individuals. The causes of fatigue are multi-factorial. Anaemia (low red blood count) is an important and common cause of fatigue, occurring in over two-thirds of patients in palliative care. Up to 50% of this anaemia may be related to iron deficiency. Studies have shown that correcting anaemia improves quality of life.
Currently neither fatigue nor anaemia in palliative cancer care have specific treatments, other than treating the underlying cancer when possible. The standard management of anaemia is with oral iron supplementation or blood transfusion from a donor. Oral iron supplementation is cheap and easily dispensed. However, it corrects anaemia slowly. Furthermore, there are issues with adherence as certain patients are unable to tolerate oral iron supplementation due to the gastrointestinal side-effects such as diarrhoea or constipation. For severe anaemia the mainstay of treatment is blood transfusion but this carries high costs, has limited supply and can lead to potential complications.
New intravenous (injected) iron products are safe to deliver and offer the potential for an effective treatment to be applied where currently no treatment is given. Studies have shown that intravenous iron results in a quicker rise in haemoglobin (red blood cells). Intravenous iron has also been shown to be better tolerated than the oral formulation because it has less gastrointestinal side-effects.
Currently the is no evidence relating to the use of intravenous iron in palliative cancer care to treat anaemia related symptoms and its effects on the patients immune system response, tumour spread and the gut bacteria. This feasibility study aims to explore its use in the treatment of anaemia and the impact on fatigue and quality of life in such patients and to inform the design of a large definitive study.
REC name
East Midlands - Nottingham 2 Research Ethics Committee
REC reference
18/EM/0196
Date of REC Opinion
28 Aug 2018
REC opinion
Further Information Favourable Opinion