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082 _ _ |a 610
100 1 _ |a Schmidt, Martina
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245 _ _ |a Cancer-related fatigue: Towards a more targeted approach based on classification by biomarkers and psychological factors.
260 _ _ |a Bognor Regis
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500 _ _ |a #EA:C110#LA:C110# / 2024 Mar 15;154(6):1011-1018
520 _ _ |a 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.
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650 _ 7 |a breast cancer
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650 _ 7 |a cancer survivorship care
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650 _ 7 |a fatigue
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650 _ 7 |a inflammation
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650 _ 7 |a patient-reported outcomes
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700 1 _ |a Maurer, Tabea
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700 1 _ |a Behrens, Sabine
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700 1 _ |a Seibold, Petra
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700 1 _ |a Obi, Nadia
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700 1 _ |a Chang-Claude, Jenny
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700 1 _ |a Steindorf, Karen
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773 _ _ |a 10.1002/ijc.34791
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