Iron and cancer treatment: why clinical practice needs to change

At IMCID 2025, Prof. Livio Blasi highlights the need to include iron supplementation as a standard component of cancer treatment to prevent clinical complications and reduce healthcare costs.

During the 9th edition of the International Multidisciplinary Course on Iron Deficiency (IMCID), held in Palermo on April 3–4, 2025, the focus was on the latest clinical evidence and most effective strategies for addressing iron deficiency. Offering an oncologist’s perspective — alongside Prof. Sandro Barni (read the interview here) — was Prof. Livio Blasi, Head of Medical Oncology at Civic Hospital Cristina Benfratelli in Palermo, who stressed the need for iron deficiency management to become a routine part of oncological care.

Professor, IMCID is now recognized as a leading platform for scientific discussion on iron deficiency. What made this edition particularly relevant from a clinical point of view?

IMCID has successfully “invented” a format that is as useful as it is necessary. It’s an excellent congress, because it takes a multidisciplinary approach to a topic that is often overlooked—iron deficiency. Events like this are crucial not only for staying updated, but also for keeping pace with complementary therapies that, for oncologists, can make a big difference in patient management.

Iron-deficiency anaemia in cancer patients is a serious issue. What are the most recent recommendations for managing it?

We must remember that iron is the key element required to synthesize haemoglobin. Without iron, haemoglobin can’t be produced, and anaemia quickly develops—especially in patients undergoing myelotoxic treatments. Not just chemotherapy, but also newer drugs like immunotherapy, CDK inhibitors, TKIs, and PARP inhibitors can all contribute to significant anaemia.
If we fail to act in time, we risk losing valuable therapeutic windows: treatments may be delayed, interrupted, or replaced with blood transfusions and other expensive or risky interventions. And all this ultimately affects patient survival.

So, in your view, what role should iron supplementation play in treatment protocols?

I believe we should begin integrating iron supplementation early in the oncology treatment path, especially for patients with low haemoglobin levels. Continuous administration isn’t always necessary: flexible and well-structured strategies can work well. But we need a cultural shift.Properly managed iron supplementation can help avoid costly erythropoiesis-stimulating agents and significantly reduce the need for transfusions. In short, it’s time for iron management to become a standard part of our oncological therapeutic toolkit.

With a pragmatic, clinical approach, Prof. Blasi used his IMCID 2025 intervention to underline the importance of recognizing iron deficiency and anaemia as fundamental aspects of oncology care. Preventing iron deficiency is not just a medical priority—it’s a strategic choice that can improve treatment efficacy, reduce healthcare costs, and protect patient quality of life.

The Abstract Book of the 9^th IMCID – International Multidisciplinary Course on Iron Deficiency, held in Palermo (Sicily, Italy) from 3 to 4 April 2025, has been published as Supplement n°3 of the last issue of May 2025 of the international journal Blood Transfusion (IF=2.4).
Download the abstract book here!