Preoperative Intravenous Iron Therapy in Patients With Gastric Cancer (IRONSTOMACH)
Primary Purpose
Gastric Cancer, Anemia, Surgery
Status
Not yet recruiting
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Ferric carboxymaltose
Placebos
Sponsored by
About this trial
This is an interventional prevention trial for Gastric Cancer
Eligibility Criteria
Inclusion Criteria:
- Patients with gastric cancer who will undergo a gastrectomy
Exclusion Criteria:
- Patients under 18 years old
- Patients not in full understanding
- Hemoglobin levels > 155 g/l for women and >167 g/l for men (upper reference limits for the laboratory of Helsinki University Hospital district) preoperatively.
- Transferrin saturation level >50%
- Emergency gastrectomy
- Palliative gastrectomy
- Acute bacterial infection
- Known hypersensitivity to the active substance, to ferric carboxymaltose or any of its excipients, or to other parental iron products
- Clinical evidence of iron overload or disturbances in the utilisation of iron
- Patients <35 kg
- Dialysis therapy for chronic renal failure
- Hemochromatosis
- Polycythemia vera
- Pregnancy
- Patients in need of direct blood transfusion ( Criteria for this are hemoglobin < 80 g/l or < 90 g/l if the patient is symptomatic or has a history of heart disease)
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Intervention
Placebo
Arm Description
IV-iron substitution: The intravenous iron formulation used in the study is ferric carboxymaltose and it will be administered two to four weeks before the surgery, aiming at four weeks. The dose of intravenous iron will be calculated according to the weight and haemoglobin level of the patients, however so that all the patients receive minimum 1000mg iv iron and the maximum dose is 20 mg/kg per day.
Placebo is NaCl 0.9% solution, which is administrated in the same way as the study drug
Outcomes
Primary Outcome Measures
The need for blood transfusion
Number of patients needing transfusions
Secondary Outcome Measures
Postoperative complications
Postoperative complications measured using Comprehensive complication index
Patients' quality of life (RAND)
RAND questionnaires
Patients' quality of life (15D)
15D questionnaires
Patients' quality of life (EQ-5D)
EQ-5D questionnaires
Patients' quality of life (FRAIL)
FRAIL questionnaires
Patients' quality of life (PRISMA-7)
PRISMA-7 questionnaires
Patients' quality of life (GSRS)
GSRS questionnaires
Patients' quality of life (IDQ)
IDQ questionnaires
Patients' haemoglobin and iron parameter levels
Patients' haemoglobin and iron parameter levels
Patients' haemoglobin and iron parameter levels
Patients' haemoglobin and iron parameter levels
Patients' haemoglobin and iron parameter levels
Patients' haemoglobin and iron parameter levels
Re-admission
Patient re-admission rates
90-day mortality
90-day mortality
Overall survival
Overall survival
Length of hospital stay
Length of hospital stay
Use of IV iron after operation
Number of doses and median dose of IV iron
Full Information
NCT ID
NCT04168346
First Posted
November 12, 2019
Last Updated
November 16, 2019
Sponsor
Helsinki University Central Hospital
1. Study Identification
Unique Protocol Identification Number
NCT04168346
Brief Title
Preoperative Intravenous Iron Therapy in Patients With Gastric Cancer
Acronym
IRONSTOMACH
Official Title
Preoperative Intravenous Iron Therapy in Patients With Gastric Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
November 2019
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 2019 (Anticipated)
Primary Completion Date
November 2021 (Anticipated)
Study Completion Date
November 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Helsinki University Central Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
5. Study Description
Brief Summary
The main objective of this investigator initiated study is to study if preoperative intravenous iron is effective in reducing need for allogenic blood transfusion in patients with gastric cancer who will undergo a standardized gastrectomy including both total and subtotal gastrectomies. The hypothesis is that intravenous iron reduces the need for perioperative blood transfusions.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Cancer, Anemia, Surgery, Iron Deficiency Anemia, Surgery--Complications
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
202 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Intervention
Arm Type
Experimental
Arm Description
IV-iron substitution: The intravenous iron formulation used in the study is ferric carboxymaltose and it will be administered two to four weeks before the surgery, aiming at four weeks. The dose of intravenous iron will be calculated according to the weight and haemoglobin level of the patients, however so that all the patients receive minimum 1000mg iv iron and the maximum dose is 20 mg/kg per day.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo is NaCl 0.9% solution, which is administrated in the same way as the study drug
Intervention Type
Drug
Intervention Name(s)
Ferric carboxymaltose
Intervention Description
Ferric carboxymaltose iv infusion
Intervention Type
Drug
Intervention Name(s)
Placebos
Intervention Description
NaCl 0.9% infusion
Primary Outcome Measure Information:
Title
The need for blood transfusion
Description
Number of patients needing transfusions
Time Frame
Within 30 days from the day of the operation
Secondary Outcome Measure Information:
Title
Postoperative complications
Description
Postoperative complications measured using Comprehensive complication index
Time Frame
Within 30 days from operation
Title
Patients' quality of life (RAND)
Description
RAND questionnaires
Time Frame
One and six months after the surgery
Title
Patients' quality of life (15D)
Description
15D questionnaires
Time Frame
One and six months after the surgery
Title
Patients' quality of life (EQ-5D)
Description
EQ-5D questionnaires
Time Frame
One and six months after the surgery
Title
Patients' quality of life (FRAIL)
Description
FRAIL questionnaires
Time Frame
One and six months after the surgery
Title
Patients' quality of life (PRISMA-7)
Description
PRISMA-7 questionnaires
Time Frame
One and six months after the surgery
Title
Patients' quality of life (GSRS)
Description
GSRS questionnaires
Time Frame
One and six months after the surgery
Title
Patients' quality of life (IDQ)
Description
IDQ questionnaires
Time Frame
One and six months after the surgery
Title
Patients' haemoglobin and iron parameter levels
Description
Patients' haemoglobin and iron parameter levels
Time Frame
At the time of hospital discharge (estimated on average 10 days after surgery)
Title
Patients' haemoglobin and iron parameter levels
Description
Patients' haemoglobin and iron parameter levels
Time Frame
One month after the surgery
Title
Patients' haemoglobin and iron parameter levels
Description
Patients' haemoglobin and iron parameter levels
Time Frame
Three months after the surgery
Title
Re-admission
Description
Patient re-admission rates
Time Frame
30 days after discharge from hospital
Title
90-day mortality
Description
90-day mortality
Time Frame
Within 90 days from operation
Title
Overall survival
Description
Overall survival
Time Frame
1, 3 and 5 years from operation
Title
Length of hospital stay
Description
Length of hospital stay
Time Frame
Within hospital stay, on average 7 - 14 days
Title
Use of IV iron after operation
Description
Number of doses and median dose of IV iron
Time Frame
Within 3 months from operation
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
- Patients with gastric cancer who will undergo a gastrectomy
Exclusion Criteria:
Patients under 18 years old
Patients not in full understanding
Hemoglobin levels > 155 g/l for women and >167 g/l for men (upper reference limits for the laboratory of Helsinki University Hospital district) preoperatively.
Transferrin saturation level >50%
Emergency gastrectomy
Palliative gastrectomy
Acute bacterial infection
Known hypersensitivity to the active substance, to ferric carboxymaltose or any of its excipients, or to other parental iron products
Clinical evidence of iron overload or disturbances in the utilisation of iron
Patients <35 kg
Dialysis therapy for chronic renal failure
Hemochromatosis
Polycythemia vera
Pregnancy
Patients in need of direct blood transfusion ( Criteria for this are hemoglobin < 80 g/l or < 90 g/l if the patient is symptomatic or has a history of heart disease)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Arto Kokkola, MD
Phone
+358-9-4711
Email
arto.kokkola@hus.fi
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Arto Kokkola, MD
Organizational Affiliation
Helsinki University Central Hospital
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
No
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Preoperative Intravenous Iron Therapy in Patients With Gastric Cancer
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