{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:14:12Z","timestamp":1783224852952,"version":"3.54.6"},"reference-count":18,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: In Japan, cancer-related anemia (CRA) is common, and erythropoiesis-stimulating agents (ESAs) are not approved for chemotherapy-induced anemia. Modern intravenous (IV) iron formulations, such as ferric carboxymaltose (FCM) and ferric derisomaltose (FDI), enable high-dose repletion; however, real-world evidence in ESA-free oncology settings remains limited. Methods: This single-center retrospective study included patients with CRA (N = 55) who received high-dose IV iron (FCM or FDI). Iron phenotypes were classified as absolute iron deficiency (ID), functional ID, or non-ID. The primary endpoint was hemoglobin (Hb) change from baseline to approximately 1 month (21\u201345 days) in the non-transfused patients. Secondary endpoints included responder rate (\u0394Hb \u2265 1.0 g\/dL), transfusion avoidance rate, dosing adequacy relative to Ganzoni-calculated iron deficit, and safety, particularly hypophosphatemia. Results: Among the non-transfused patients, mean Hb increased from 8.76 \u00b1 1.34 g\/dL to 9.73 \u00b1 1.75 g\/dL (mean \u0394Hb +0.92 \u00b1 1.44 g\/dL; p &lt; 0.001). The responder and transfusion avoidance rates were 48.9% and 81.8%, respectively. Functional ID was most prevalent (52.7%), with clinically meaningful Hb responses. A total of 38.2% achieved approximately 1000 mg dosing. The safety profile was excellent, and no infusion reactions or symptomatic hypophosphatemia was observed (median serum phosphate changed from 3.4 [3.0\u20133.9] to 3.2 [2.7\u20133.8] mg\/dL). Conclusions: In this real-world Japanese oncology setting where ESAs were not available for chemotherapy-induced anemia, high-dose IV iron monotherapy (FCM or FDI) was well tolerated and was associated with modest short-term Hb increases and a high observed rate of transfusion avoidance within a 21\u201345-day assessment window. These findings suggest that a proactive, TSAT-guided IV iron therapy approach may be a pragmatic option for selected patients; however, durability beyond 1 month, optimal re-dosing, and generalizability require confirmation in larger, longer prospective studies.<\/jats:p>","DOI":"10.3390\/cancers18030416","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:56:12Z","timestamp":1769615772000},"page":"416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High-Dose Intravenous Ferric Carboxymaltose\/Derisomaltose Without ESAs for Cancer-Related Anemia in Japan: A Retrospective Single-Center Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-5130","authenticated-orcid":false,"given":"Shinya","family":"Kajiura","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"},{"name":"Palliative Care Team, Toyama University Hospital, Toyama 930-0194, Japan"},{"name":"Third Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudai","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Hospital Pharmacy, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"},{"name":"Palliative Care Team, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"},{"name":"Palliative Care Team, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutatsu","family":"Yuki","sequence":"additional","affiliation":[{"name":"Palliative Care Team, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihito","family":"Horikawa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mutsuki","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Nagata","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iori","family":"Motoo","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Ando","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6888-0310","authenticated-orcid":false,"given":"Ichiro","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8022-196X","authenticated-orcid":false,"given":"Atsushi","family":"Kato","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, University of Toyama, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4205-9540","authenticated-orcid":false,"given":"Ryuji","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Palliative Medicine, Toyama University Hospital, Toyama 930-0194, Japan"},{"name":"Palliative Care Team, Toyama University Hospital, Toyama 930-0194, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1093\/annonc\/mds112","article-title":"Prevalence and management of cancer-related anaemia, iron deficiency and the specific role of i.v. iron","volume":"23","author":"Aapro","year":"2012","journal-title":"Ann. 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