A prospective study of intravenous iron effectiveness on quality of life and functional outcomes in patients with cancer

Cancer-related anemia (CRA) is a common complication during and after cancer treatment. It contributes to impaired functional capacity, reduced quality of life (QoL), and worse prognosis Iron deficiency (ID) is a frequent underlying cause; therefore, intravenous iron replacement may improve both hematologic and patient-centered outcomes. However, prospective data on QoL and functional status in CRA remain limited. We prospectively evaluated the effects of ferric carboxymaltose (FCM) on QoL and cardiorespiratory fitness in cancer patients with ID. A prospective observational study was conducted between March and October 2023 with patients suffering from ID and undergoing FCM iron supplementation. The study involved QoL measurement through the SF-36 questionnaire and cardiorespiratory fitness assessment using the six-minute walk test (6MWT). Primary endpoints were physical functioning and vitality (energy/fatigue) subscales of SF-36. Secondary endpoints were six-minute walking distance and other subscales of SF-36. Data analysis was performed using various statistical tests, with a post-hoc power analysis showed sufficient (> 99%) power for primary endpoints. Thirty patients were enrolled, most commonly with colon (40%) and breast cancer (20%); 70% had ECOG 1 status. FCM led to significant improvements in hemoglobin and iron indices. While 6MWT distance showed a non-significant upward trend, SF-36 scores improved significantly in physical functioning, vitality, and emotional well-being, underscoring a multidimensional benefit on QoL. Intravenous iron replacement in cancer patients with ID improves hematologic parameters and confers meaningful gains in physical functioning, vitality, and emotional health. These findings support systematic iron assessment and supplementation as part of supportive oncology care.