Pretreatment Fatigue Could Indicate Worse Overall Survival, Increased Adverse Effects

In a study, median OS times for patients reporting such fatigue were approximately 26% to 45% shorter than those for patients without baseline fatigue.

Patients with cancer had lower overall survival (OS) times and a greater number of adverse events (AEs) if they reported clinically significant fatigue at the start of their treatment, according to a study published in JCO Oncology Practice. The investigators concluded that baseline fatigue may be an important prognostic factor in oncology treatment trials.

The study authors analyzed 4 clinical trials, including 2 that enrolled patients with advanced hormone-resistant prostate cancer and 2 that enrolled patients with advanced non-small cell lung cancer. All participants completed quality-of-life and symptom surveys at the beginning of the trial, using either the Functional Assessment of Cancer Therapy or the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30. The investigators used the midpoint of each scale as a cutoff in determining whether a patient had reported a clinically significant level of fatigue at the start of treatment.

According to the results of the study, median OS times for patients reporting such fatigue were approximately 26% to 45% shorter than those for patients without baseline fatigue. Further, in the 2 prostate cancer studies analyzed, patients reporting clinically significant fatigue before cancer treatment were more likely to experience severe AEs from chemotherapy. These included gastrointestinal, neurological, and constitutional AEs. This association was not seen in the patients participating in the lung cancer trials.

“Our findings suggest that if there is evidence of significant fatigue, patients and families should be informed and counseled on possible higher risk of poorer outcomes,” said Julia Mo, BS, in a press release. “In addition, strategies may be developed to impact fatigue and possibly long-term outcomes.”

The investigators said that, although numerous studies have assessed how fatigue related to cancer treatment is associated with patient survival outcomes, few have analyzed the relationship between pretreatment fatigue and patient morbidity and mortality.

REFERENCE

Pretreatment fatigue can mean worse survival outcomes for patients with cancer [news release]. EurekAlert; July 29, 2021. Accessed August 2, 2021. https://www.eurekalert.org/news-releases/923941