title: Recommendations for high-priority research on cancer-related fatigue in children and adults.
abstract: Over the past decades, some scientific progress has been made in understanding and treating cancer-related fatigue (CRF). However, three major problems have limited further progress: lack of agreement about measurement, inadequate understanding of the underlying biology, and problems in the conduct of clinical trials for CRF. This commentary reports the recommendations of a National Cancer Institute Clinical Trials Planning Meeting and an ongoing National Cancer Institute working group to address these problems so that high-priority research and clinical trials can be conducted to advance the science of CRF and its treatment. Recommendations to address measurement issues included revising the current case definition to reflect more rigorous criteria, adopting the Patient Reported Outcomes Measurement Information System fatigue scales as standard measures of CRF, and linking legacy measures to the scales. With regard to the biology of CRF, the group identified the need for longitudinal research to examine biobehavioral mechanisms underlying CRF and testing mechanistic hypotheses within the context of intervention research. To address clinical trial issues, recommendations included using only placebo-controlled trial designs. setting eligibility to minimize sample heterogeneity or enable subgroup analysis, establishing a CRF severity threshold for participation in clinical trials, conducting dissemination trials of efficacious interventions (such as exercise), and combining nonpharmacologic and pharmacologic interventions to exploit the potential synergy between these approaches. Accomplishing these goals has the potential to advance the science of CRF and improve the clinical management of this troubling symptom.
authors.affiliation: Affiliations of authors: Thomas Jefferson University, Philadelphia, PA (AMB); University of California-Los Angeles, Los Angeles, CA (MRI); Children's National Medical Center, Washington, DC (PH); Emory University, Atlanta, GA (AM); University of Nebraska Medical Center, Omaha, NE (AB); Moffitt Cancer Center, Tampa, FL (PJ); University of California-San Diego, San Diego, CA (SA-I); University of North Carolina at Chapel Hill, Chapel Hill, NC (RBR); University of Rochester, Rochester, NY (KM); National Cancer Institute, Bethesda, MD (AOM); Northwestern University, Chicago, IL (J-SL, DC); M.D. Anderson Cancer Center, Houston, TX (MF).
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Barsevick
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.forename: Pamela
authors.initials: P
authors.lastname: Hinds
authors.forename: Andrew
authors.initials: A
authors.lastname: Miller
authors.forename: Ann
authors.initials: A
authors.lastname: Berger
authors.forename: Paul
authors.initials: P
authors.lastname: Jacobsen
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
authors.forename: Karen
authors.initials: K
authors.lastname: Mustian
authors.forename: Ann
authors.initials: A
authors.lastname: O'Mara
authors.forename: Jin-Shei
authors.initials: JS
authors.lastname: Lai
authors.forename: Michael
authors.initials: M
authors.lastname: Fisch
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications / Q000209:etiology; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods*; D003863:Depression / Q000150:complications / Q000209:etiology; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D015444:Exercise; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D000077408:Modafinil; D009043:Motor Activity; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D012107:Research Design; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications / Q000209:etiology; D016896:Treatment Outcome; D014481:United States
chemical_list: D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D018765:Dopamine Uptake Inhibitors; D016642:Bupropion; D000077408:Modafinil
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