Encouraging results prompt larger scale study for cancer patients with anaemia

A study to look at potential treatment for advanced cancer patients with anaemia and fatigue has shown such encouraging results that researchers now want to run it again on a larger scale.

The ICaRAS randomised controlled trial: Intravenous iron to treat anaemia in people with advanced cancer, was carried out over a 16-month period by The Royal Wolverhampton NHS Trust, Nottingham’s Queen's Medical Centre and students from Wolverhampton and Nottingham Universities.

The team worked with hospices and, in addition, an animation was created featuring a simple explanation of the study along with patient feedback. People with advanced cancer, receiving palliative care, often suffer anaemia and it can be difficult to identify effective and safe treatment. Iron tablets often cause unwanted side effects such as constipation and abdominal pain, and blood transfusions only offer short- term benefits.

In this study, intravenous iron - which has had promising results as an effective anaemia treatment - was taken by patients with advanced cancer. No serious adverse reactions were reported.

Dr Ed Dickson (pictured, R) was the Clinical Research Fellow running the study at the time, based at the
University of Nottingham.

He said: “For the first time these results indicate that intravenous iron may be effective for advanced cancer patients suffering from anaemia and fatigue. This is an exciting outcome that we need to explore further with a larger scale study to confirm these promising results.

“Our study teams have been able to work closely with palliative care teams and this has been beneficial for all. This collaboration has meant we’ve overcome the unique challenges encountered with research in hospice and palliative care settings. Together we are now working on a larger scale, multi-centre research study to be delivered to participants
throughout the UK.

“The animation has been produced by Sorrel Milne who is an experienced animator and illustrator who has worked with the research group previously and has experience of communicating outcomes from research studies. This animation has also given us valuable feedback for reflection and more importantly given participants a voice.

“This Dying Matters Week we want to highlight the research that is taking place as well as thank all of the patients who took part. They have made a difference today for patients tomorrow.”

Patients said: 

“I wanted to make things better for other people and myself”

“It was a chance to learn more about my condition, the more you know the less frightening it all seems”

“When you’re doing the study to help other people you just do it”

Professor Matthew Brookes (pictured L), Clinical Director of the Clinical Research Network West Midlands (CRN WM), was the Principal Investigator in Wolverhampton.

He added: “The trial has given us a lot of important information about potential treatment options for the future for advanced cancer patients with anaemia and demonstrated how we can widen participation.

“It has also shown us that patients’ quality of life can be improved and that was an important factor for participants. Patients with advanced cancer are already going through a difficult time and the fatigue that anaemia brings means they struggle to do the things they enjoy. Treatment to lift their energy levels also lifts their spirits and this can’t be underestimated.

“This research has proved an invaluable opportunity for our students across Wolverhampton and Nottingham too and we hope it has had a positive impact on their future career aspirations.”

Professor Brookes added that the animation that has been developed would hopefully prompt more people to Be Part of Research.

All participants – 35 in total - were receiving palliative care for their cancer, were anaemic and had reported fatigue as a significant symptom. The study lasted for eight weeks for each and they received either a dose of intravenous iron or a placebo (saline). To keep things fair patients did not know which treatment they were given.

Patients ranged in age from 58 to 93 and the study outcome measures included change in blood tests, change in daily step count and change in quality of life after their infusion.