High Dose IV Iron Plus ESA in Chemotherapy-induced Anemia

Inclusion Criteria:

• Patient who has signed a written consent
• Age ≥ 19 ③ Histologically diagnosed advanced/metastatic solid cancer
• Patients who have received myelosuppressive chemotherapy for palliativepurposes within 1 month of participating in the study and plan to proceedwith chemotherapy while participating in this study
• Anemia with functional iron deficiency

1. Hemoglobin <10g/dL
2. functional iron deficiency: transferrin saturation <50% AND serumferritin 30-800ng/mL ⑤ ECOG performance status 0-2 ⑥ life expectancy ≥ 24weeks

Exclusion Criteria:

• Absolute iron deficiency (serum ferritin <30 ng/mL AND transferrin saturation <20%) orno iron deficiency (serum ferritin ≥800 ng/mL OR transferrin saturation ≥50%)
• If there is another cause of anemia other than chemotherapy-induced anemia (eg,vitamin B12 or folic acid deficiency, hemolytic anemia, myelodysplastic syndrome,etc.)
• Ongoing bleeding at the time of study registration
• Patients who require rapid blood transfusion at the time of studyregistration (eg, rapidly progressing anemia)
• Presence of bone marrow tumor invasion
• Receiving erythropoiesis stimulating agents within 3 weeks ofstudy registration or have a history of oral or intravenousiron administration or blood transfusion within 2 weeks ofstudy registration
• History of venous thromboembolism within 6 months ortaking anticoagulants at the time of study registration
• Past or family history of hemochromatosis ⑨ Historyof hypersensitivity to iron treatment orerythropoiesis stimulating agents ⑩ Uncontrolledacute or chronic infection ⑪ Renal dysfunction (serum creatinine ≥2.0 mg/dL, or glomerularfiltration rate <30 mL/min/1.73 m2) or liverdysfuction (AST or ALT 3 times or more the upperlimit of normal) ⑫ Pregnant or lactating women