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@ARTICLE{Schmidt:285365,
      author       = {M. Schmidt$^*$ and T. Maurer and S. Behrens$^*$ and P.
                      Seibold$^*$ and N. Obi and J. Chang-Claude$^*$ and K.
                      Steindorf$^*$},
      title        = {{C}ancer-related fatigue: {T}owards a more targeted
                      approach based on classification by biomarkers and
                      psychological factors.},
      journal      = {International journal of cancer},
      volume       = {154},
      number       = {6},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2023-02334},
      pages        = {1011-1018},
      year         = {2024},
      note         = {#EA:C110#LA:C110# / 2024 Mar 15;154(6):1011-1018},
      abstract     = {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.},
      keywords     = {breast cancer (Other) / cancer survivorship care (Other) /
                      fatigue (Other) / inflammation (Other) / patient-reported
                      outcomes (Other)},
      cin          = {C110 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37950650},
      doi          = {10.1002/ijc.34791},
      url          = {https://inrepo02.dkfz.de/record/285365},
}