[Status and prospect of cancer chemotherapy-induced anemia]

Chemotherapy-induced anemia (CIA) is one of the most common complications in cancer patients. If CIA treatment is not effective, it will affect the normal implementation of chemotherapy regimens, and reduce the quality of life of patients and shorten clinical survival. At present, CIA has serious shortcomings in treatment rate and unsatisfactory therapeutic effect. It is often forced to reduce the dose of chemotherapy or delay chemotherapy due to anemia that cannot be rapidly and effectively treated in clinical practice. These problems are mainly related to factors such as complex etiology of the disease, late timing of clinical intervention, and certain limitations in existing treatment options. Therefore, disease management needs to further strengthen the concept of early diagnosis and early treatment to avoid the increased clinical burden due to the severity of anemia. Meanwhile, with the in-depth understanding of the mechanism of anemia, new drug research and development based on the comprehensive regulatory mechanism of hypoxia-inducible factor (HIF) has begun in clinical practice. A phase Ⅲ clinical study of Roxostat in the treatment of chemotherapy-induced anemia in patients with non-medullary malignancies was presented at the European Society of Medical Oncology (ESMO) conference in 2023. This hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) drug is an oral preparation, which has shown good efficacy and safety in the study, and has superior compliance compared with recombinant human erythropoietin-α (rHuEPO-α). Starting from the re-understanding of the mechanism of CIA, this review analyzes the current diagnosis and treatment dilemmas of CIA, puts forward suggestions in combination with the "Guildlines of Chinese Society of Clinical Oncology (CSCO) clinical practice in tumor-related anemia (2024)", and introduces and looks forward to HIF-PHI, a new therapeutic drug in the future.