{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T21:33:33Z","timestamp":1785879213861,"version":"3.56.0"},"reference-count":109,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Vitamin B12 (cobalamin) is a critical micronutrient involved in hematopoiesis and neurological function. Its deficiency, commonly presenting with anemia and neurological symptoms, is particularly relevant in oncology. While anemia affects up to 60% of cancer patients, the contribution of vitamin B12 deficiency to cancer-related anemia remains underexplored. Additionally, cobalamin-related neuropathy manifests or exacerbates existing chemotherapy-induced peripheral neuropathy (CIPN), a serious side effect of chemotherapy. Prevalence estimates in cancer populations range widely (6\u201348%), with higher rates in elderly and gastrointestinal cancer patients. This review summarizes current evidence on the prevalence and implications of both vitamin B12 deficiency and excess in patients with solid tumors. It discusses laboratory markers (such as serum vitamin B12, holotranscobalamin, methylmalonic acid, and homocysteine) that could improve diagnostic accuracy in oncology settings. Additionally, it evaluates supplementation strategies and discusses its role in mitigating CIPN. Additionally, it addresses B12\u2032s emerging immunological role in cancer therapy.<\/jats:p>","DOI":"10.3390\/nu17203272","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T16:13:03Z","timestamp":1760717583000},"page":"3272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Vitamin B12 in Cancer Patients: Clinical Insights into Deficiency, Excess, Diagnosis, and Management"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6188-7328","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Osmola","sequence":"first","affiliation":[{"name":"Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8533-4557","authenticated-orcid":false,"given":"Martyna","family":"Tyszka","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Jirka","sequence":"additional","affiliation":[{"name":"IMAD, Hepato-Gastroenterology & Digestive Oncology, University Hospital of Nantes, 44-000 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3694-4076","authenticated-orcid":false,"given":"Olga","family":"Ciepiela","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4572-6641","authenticated-orcid":false,"given":"Aleksandra","family":"Kapa\u0142a","sequence":"additional","affiliation":[{"name":"Department of Oncology Diagnostics, Cardio-Oncology and Palliative Medicine, Maria Sk\u0142odowska-Curie National Research Institute of Oncology, 02-871 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Vincenzo","family":"Lenti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Therapeutics, University of Pavia, 27-100 Pavia, Italy"},{"name":"First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, 27-100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Matysiak-Budnik","sequence":"additional","affiliation":[{"name":"IMAD, Hepato-Gastroenterology & Digestive Oncology, University Hospital of Nantes, 44-000 Nantes, France"},{"name":"CHU de Nantes, INSERM, Center for Research in Transplantation and Translational Immunology, UMR 1064, Institut de Transplantation Urologie-N\u00e9phrologie, Nantes Universit\u00e9, 44-000 Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref_1","unstructured":"Institute of Medicine (US) Standing Committee (1998). 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