TY  - JOUR
AU  - Schmidt, Martina
AU  - Maurer, Tabea
AU  - Behrens, Sabine
AU  - Seibold, Petra
AU  - Obi, Nadia
AU  - Chang-Claude, Jenny
AU  - Steindorf, Karen
TI  - Cancer-related fatigue: Towards a more targeted approach based on classification by biomarkers and psychological factors.
JO  - International journal of cancer
VL  - 154
IS  - 6
SN  - 0020-7136
CY  - Bognor Regis
PB  - Wiley-Liss
M1  - DKFZ-2023-02334
SP  - 1011-1018
PY  - 2024
N1  - #EA:C110#LA:C110# / 2024 Mar 15;154(6):1011-1018
AB  - Cancer-related fatigue is a frequent, burdensome and often insufficiently treated symptom. A more targeted treatment of fatigue is urgently needed. Therefore, we examined biomarkers and clinical factors to identify fatigue subtypes with potentially different pathophysiologies. The study population comprised disease-free breast cancer survivors of a German population-based case-control study who were re-assessed on average 6 (FU1, n = 1871) and 11 years (FU2, n = 1295) after diagnosis. At FU1 and FU2, we assessed fatigue with the 20-item multidimensional Fatigue Assessment Questionnaire and further factors by structured telephone-interviews. Serum samples collected at FU1 were analyzed for IL-1ß, IL-2, IL-4, IL-6, IL-10, TNF-a, GM-CSF, IL-5, VEGF-A, SAA, CRP, VCAM-1, ICAM-1, leptin, adiponectin and resistin. Exploratory cluster analyses among survivors with fatigue at FU1 and no history of depression yielded three clusters (CL1, CL2 and CL3). CL1 (n = 195) on average had high levels of TNF-α, IL1-β, IL-6, resistin, VEGF-A and GM-CSF, and showed high BMI and pain levels. Fatigue in CL1 manifested rather in physical dimensions. Contrarily, CL2 (n = 78) was characterized by high leptin level and had highest cognitive fatigue. CL3 (n = 318) did not show any prominent characteristics. Fatigued survivors with a history of depression (n = 214) had significantly higher physical, emotional and cognitive fatigue and showed significantly less amelioration of fatigue from FU1 to FU2 than survivors without depression. In conclusion, from the broad phenotype 'cancer-related fatigue' we were able to delineate subgroups characterized by biomarkers or history of depression. Future investigations may take these subtypes into account, ultimately enabling a better targeted therapy of fatigue.
KW  - breast cancer (Other)
KW  - cancer survivorship care (Other)
KW  - fatigue (Other)
KW  - inflammation (Other)
KW  - patient-reported outcomes (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:37950650
DO  - DOI:10.1002/ijc.34791
UR  - https://inrepo02.dkfz.de/record/285365
ER  -