Cancer-induced Anemia (CIA) in Treatment-naïve Patients: Focus on Baseline Prevalence, Pathophysiology, Clinical Implications and Management

Introduction: Cancer-Induced Anemia (CIA) in treatment-naïve patients is a common yet under-investigated complication that significantly impacts quality of life (QoL) and survival. This review consolidates evidence on the CIA's baseline prevalence, pathophysiology, clinical implications, and management. Methods: A narrative literature review was conducted using databases like PubMed and Scopus to identify studies on prevalence, pathophysiology, and management of CIA in treatment-naïve patients. Key articles and guidelines were included to synthesize current evidence. Results: The prevalence of CIA varies widely (18-87%), with the highest rates in gastrointestinal, gynecologic, and hematologic cancers. Its pathophysiology is driven by inflammation-mediated hepcidin upregulation, functional iron deficiency, and suppressed erythropoiesis. Clinically, CIA exacerbates fatigue and cognitive dysfunction, acting as an independent prognostic factor for treatment resistance and decreased survival. Current management relies on erythropoiesis-stimulating agents (ESAs), intravenous iron, and transfusions, which offer symptomatic relief but are limited by thromboembolic risks and transient efficacy. Emerging therapies, such as anti-hepcidin agents and HIF stabilizers, show promise by targeting underlying disease mechanisms. Discussion: The findings underscore the multifactorial nature of CIA and highlight the need for early diagnosis and multidisciplinary management. While novel therapies are promising, their long-term efficacy and safety require validation. Regional disparities in prevalence and management call for international guidelines and biomarker-directed approaches Conclusion: Integrating CIA management into initial oncology care, supported by standardized screening and research, is crucial for improving patient outcomes and QoL.