Evidence map›Paper›PMID 35576697›Full record

SynthesisESMO open2022

Incidence of fatigue associated with immune checkpoint inhibitors in patients with cancer: a meta-analysis.

I Kiss, M Kuhn, K Hrusak, T Buchler

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in ESMO open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Cancer-related fatigue during treatment with neoadjuvant and/or adjuvant immune checkpoint inhibitors: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Pooled it
  2. Pooled it
  3. Trial
  4. Beyond tumor response: hope and decision regret during immunotherapy for hepatocellular carcinoma.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
    Article
  5. Asthenia in cancer patients receiving immune checkpoint Inhibitors (ICIs): the MOUSEION-11 systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  6. Article
  7. Article
  8. Article
  9. Objective measurement of physical activity levels and patient-reported outcomes in cancer patients receiving immune-checkpoint inhibitors: a cross-sectional study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  10. Incidence and predictors of immune checkpoint inhibitor treatment-related cognitive impairment in a racial and ethnic diverse population.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  11. Exercising and immuno-oncology treatment (ExIO): a prospective pilot study for patients with solid tumors.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  12. Symptom clusters and network analysis of patients with intermediate and advanced liver cancer treated with targeted immunotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Article
  13. Cancer-related fatigue among patients with advanced cancer receiving immune-checkpoint inhibitors: a prospective study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
    Observational
  14. Article
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

I KissDepartment of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
M KuhnInstitute of Biostatistics and Analyses Ltd, Masaryk University, Brno, Czech Republic.
K HrusakDepartment of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic.
T BuchlerDepartment of Oncology, First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic. Electronic address: tomas.buchler@ftn.cz.
Charles University · CZMasaryk University · CZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFatigue is one of the most common adverse effects associated with cancer immunotherapy using checkpoint inhibitors (CPIs). Because treatment-related fatigue also frequently occurs in patients treated with non-immunological therapies, our study aimed to compare the incidence of fatigue in CPI-treated patients with that associated with non-immune therapies in randomised trials.

methodsPubMed and ClinicalTrials.gov were searched for phase III studies using a CPI alone or in combination with chemotherapy or non-immunologic targeted therapy in the experimental arm and control arm using inactive therapies such as placebo or observation, chemotherapy, or non-immunologic targeted therapy. Adverse events listed in the full texts as well as those available from clinicaltrials.gov were reviewed for all identified studies.

resultsA total of 60 studies involving 41 435 patients were included in the analysis. All-grade fatigue was reported in 30.4% of patients [95% confidence interval (CI) 29.9% to 31.0%] in the immunotherapy arms of the analysed studies. Using anti-programmed cell death protein 1 agents as reference, the odds ratio (OR) for fatigue was significantly higher both for anti-cytotoxic T lymphocyte-associated antigen 4 agents (OR 1.46, 95% CI 1.04-2.04) and the combination of anti-cytotoxic T lymphocyte-associated antigen 4 and anti-programmed cell death protein agents (OR 1.43, 95% CI 1.12-1.83). Fatigue was significantly less likely to occur in patients treated with CPI compared with patients receiving chemotherapy (OR 0.79, 95% CI 0.73-0.85), but significantly was more common in patients receiving the combination of CPI/chemotherapy compared with patients receiving chemotherapy alone (OR 1.12, 95% CI 1.03-1.22).

conclusionsAlthough immunotherapy using CPIs was associated with treatment-related fatigue, the occurrence of all-grade fatigue was significantly higher in patients treated with chemotherapy compared with patients receiving CPIs. The risk of fatigue was higher for CPI/chemotherapy combinations than for chemotherapy alone. These results suggest that although the effects of CPIs and chemotherapy are additive, chemotherapy was the dominant cause of treatment-related fatigue in the analysed trials.

Indexed as

Immune Checkpoint InhibitorsNeoplasmsFatigueHumansImmunotherapyIncidenceImmune Checkpoint Inhibitorscheckpoint inhibitorschemotherapyfatigueimmunotherapymeta-analysistargeted therapy

Identifiers

PMID35576697
PMCPMC9271472
OpenAlexW4280528686

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.