Ferric Carboxymaltose for Treatment of Anaemia of Cancer in Subjects With Multiple Myeloma Receiving Chemotherapy (AOC-MM)

Inclusion Criteria:

• Subjects (male or female) aged ≥18, suffering from a newly diagnosed or progressed/relapsed MM and scheduled to receive anti-myeloma treatment. Progression is defined according to "Uniform Response Criteria for Multiple Myeloma"
• Subjects with progressed/relapsed MM should have had stable disease (during the last 6 months since prior treatment).
• Life expectancy at least 6 months.
• 8.5 g/dL ≤Hb ≤11 g/dL at time of randomisation.

• Iron-restricted erythropoiesis as defined:

  • Stainable iron in bone marrow (BM) combined with transferrin saturation (TSAT) ≤20%, or

  • where the evaluation of stainable iron in BM is not possible or available:

    • ferritin >30 ng/mL (women) or >40 ng/mL (men), and
    • TSAT ≤20%
• Females of child-bearing potential must have a negative urine pregnancy test at screening.
• Before any study-specific procedure, the appropriate written informed consent must be obtained.

Exclusion Criteria:

• Any anaemia treatment within 4 weeks prior to randomisation (including red blood cell transfusions, treatment with ESA or any oral/parenteral iron preparations).
• Anthracycline containing chemotherapy regimens.
• Subjects weighing <35 kg.
• Folate deficiency (serum-folate <4.5 nmol/L) and/or Vitamin B12 deficiency (serum-cobalamin <145 pmol/L).
• Ongoing haemolysis defined as serum-haptoglobin <0.2 g/L.
• Known chronic renal failure, glomerular filtration rate <30 mL/min/m2.
• Recent (within last 4 weeks) significant bleeding/surgery, defined as drop in Hb of ≥2 g/dL.
• Clinically relevant active inflammatory disease other than MM (according to the judgement of the Investigator).
• Clinically relevant ongoing infectious disease including known human immunodeficiency virus.
• Serum ferritin >600 ng/mL.
• Ongoing significant neurological or psychiatric disorders including psychotic disorders or dementia.
• Significant cardiovascular disease prior to study inclusion including myocardial infarction within 12 months prior to study inclusion, congestive heart failure New York Heart Association Grade III or IV, or poorly controlled hypertension according to the judgment of the Investigator.
• Elevation of liver enzymes (aspartate aminotransferase, alanine aminotransferase) over 3 times above the normal range or known acute hepatic disorder.
• Subject currently is enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(ies), or subject is receiving other investigational agent(s).
• Subject of child-bearing potential is evidently pregnant (e.g., positive human chorionic gonadotropin test) or is breast feeding.
• Subject is not using adequate contraceptive precautions. Adequate contraceptive precautions are defined as those which result in a low failure rate (i.e., less than 1% per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, some intra-uterine devices, sexual abstinence or vasectomised partner. Non-childbearing potential includes being surgically sterilised at least 6 months prior to the study or post-menopausal, defined as amenorrhea for at least 12 months.
• Subject has known sensitivity to any of the products to be administered during dosing.
• Subject will not be available for follow-up assessment.
• Subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures.