Testing Treatments for Fatigue in Advanced Cancer Patients

Jenn Hoskins
6th April, 2024

Testing Treatments for Fatigue in Advanced Cancer Patients

Image Source: Natural Science News, 2024

Key Findings

  • Study at Ahvaz University compares treatments for cancer-related fatigue (CRF)
  • The trial tests methylphenidate, bupropion, ginseng, amantadine, and placebo in 255 patients
  • Machine learning will help personalize CRF treatment by predicting patient responses
Cancer-related fatigue (CRF) is a prevalent and debilitating symptom that affects many individuals battling cancer. It can significantly reduce a patient's quality of life and their ability to engage in daily activities. Despite its impact, CRF is often under-recognized and undertreated, partly due to a lack of consensus on effective management strategies. A new study by researchers at Ahvaz Jundishapur University of Medical Sciences aims to address this gap by comparing the effectiveness of several pharmacological treatments for CRF[1]. Previous research has indicated that CRF is a complex condition that is not fully understood, which poses challenges for its management[2]. While CNS stimulants like modafinil and methylphenidate have been recommended, their efficacy has been questioned[3]. Moreover, patient-reported outcomes such as fatigue have been correlated with poorer survival rates and increased adverse events during cancer treatment[4]. Pain, another common symptom in cancer patients, has been identified as a significant predictor of quality of life, further complicating the management of CRF[5]. The 5-EPIFAT study is a comprehensive trial designed to evaluate the efficacy of methylphenidate, bupropion, ginseng, and amantadine compared to a placebo in treating CRF. This study is particularly notable for its head-to-head comparison of different pharmacological agents, which has been lacking in previous research. By enrolling 255 adult patients with advanced cancer and fatigue intensity of 4 or higher on a 0-10 scale, the study aims to provide robust data on the relative effectiveness of these treatments. Over a period of 4 weeks, participants will receive one of the study drugs or a placebo. The primary measure of success will be the change in fatigue levels, as assessed by the FACIT-F scale, a tool commonly used to evaluate fatigue in individuals with chronic illness. Safety will also be a key concern, with secondary outcomes focusing on symptomatic adverse events reported by patients using the PRO-CTCAE system. One innovative aspect of the 5-EPIFAT study is the use of a machine learning algorithm for subgroup analysis. This approach could reveal patterns that predict which patients are more likely to benefit from specific treatments, paving the way for more personalized and effective management of CRF. The findings from this trial have the potential to inform clinical decision-making and improve the quality of life for many cancer patients. By providing evidence-based guidance on the use of pharmacological agents for CRF, the study could lead to the development of more targeted and effective treatment protocols. Additionally, the results might influence the design of future trials and contribute to the establishment of comprehensive CRF management guidelines. In conclusion, the 5-EPIFAT trial represents a significant step forward in the quest to understand and treat cancer-related fatigue. By directly comparing multiple drugs and employing advanced analytical techniques, the study not only aims to identify the most effective treatments but also to enhance personalized care for cancer patients suffering from this challenging condition.

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References

Main Study

1) 5-EPIFAT trial protocol: a multi-center, randomized, placebo-controlled trial of the efficacy of pharmacotherapy for fatigue using methylphenidate, bupropion, ginseng, and amantadine in advanced cancer patients on active treatment.

Published 3rd April, 2024

https://doi.org/10.1186/s13063-024-08078-w

Related Studies

2) Cancer-related fatigue treatment: An overview.

https://doi.org/10.4103/jcrt.JCRT_50_17

3) Modafinil for the treatment of fatigue in lung cancer: results of a placebo-controlled, double-blind, randomized trial.

https://doi.org/10.1200/JCO.2013.54.4346

4) Association of Fatigue and Outcomes in Advanced Cancer: An Analysis of Four SWOG Treatment Trials.

https://doi.org/10.1200/OP.20.01096

5) The relationship between pain, fatigue, sleep disorders and quality of life in adult patients with acute leukaemia: During the first year after diagnosis.

https://doi.org/10.1111/ecc.12762


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