Evidence map›Paper›PMID 39703168›Full record

ArticleThe oncologist2025

Incidence of patient-reported fatigue developing on palbociclib and endocrine therapy for advanced HR+ HER2- breast cancer.

Shadab A Rahman, Hanneke Poort, Deborah Schrag, Stephanie C Tung, Eric S Zhou, Aleta Wiley, Lauren B Finkelstein, Elkhansaa Elguenaoui, Moira Nolan, Erica L Mayer and 1 more

Abstract read
In one paragraph

Article in The oncologist, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

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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

11 authors.

Shadab A RahmanDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115, United States.
Hanneke PoortDepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA 02115, United States.
Deborah SchragDivision of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, United States.
Stephanie C TungDivision of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, United States.
Eric S ZhouDivision of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, United States.
Aleta WileyDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Lauren B FinkelsteinDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Elkhansaa ElguenaouiDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Moira NolanDepartment of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Erica L MayerDivision of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, United States.
Hadine JoffeDivision of Sleep Medicine, Harvard Medical School, Boston, MA 02115, United States.ORCID 0000-0002-7035-8249

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesFatigue is a common nonhematologic toxicity of the CDK4/6 inhibitor palbociclib in metastatic breast cancer (MBC) patients with prevalence rates of clinician-rated all-grade and grade 3/4 fatigue of 39.2% and 2.5%, respectively. We prospectively assessed the incidence of fatigue emerging on palbociclib using patient-reported measures and explored potential predictors.

methodsEighty-eight patients with HR+ HER2- MBC without fatigue initiating palbociclib with endocrine therapy were assessed before and monthly across the initial 6 cycles. Clinically meaningful levels of patient-reported fatigue (Functional Assessment of Chronic Illness Therapy Fatigue Scale, FACIT-F < 34), severity of, and functional interference due to fatigue (NCI Patient-Reported Outcomes for CTCAE, PRO-CTCAE) were assessed. Hematologic and nonhematologic predictors were examined pretreatment and concurrent with fatigue assessments.

resultsPatient-reported fatigue emerged in 21/88 patients [incidence rate 23.9% (95%CI, 15.4%-34.1%)] within 2.8 ± 1.7 treatment cycles. PRO-CTCAE-rated incidence rate of severe fatigue and fatigue interference was 14.8% (95%CI, 8.1%-23.9%) and 10.2% (95%CI, 4.8%-18.5%), respectively. Lower pretreatment absolute neutrophil count (ANC) levels predicted treatment-emergent fatigue (P =.01), but ANC levels on treatment did not (P =.78). Other pretreatment predictors were long sleep duration (P =.02) and low physical activity (trend, P =.07). Treatment-emergent fatigue was associated with objectively measured long sleep duration on treatment (P =.02), but not other measures (P ≥.35).

conclusionsOne-quarter of patients with HR+ HER2- MBC initiating palbociclib report rapidly emergent clinically meaningful fatigue, often with severe symptoms and functional interference. Treatment-emergent fatigue is associated with both pretreatment (lower ANC levels, longer sleep duration) and on-treatment (long sleep duration) hematologic and nonhematologic profiles.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsFatiguePiperazinesPyridinesAdultAgedAged, 80 and overErb-b2 Receptor Tyrosine KinasesFemaleHumansIncidenceMiddle AgedPatient Reported Outcome MeasuresProspective StudiesReceptors, EstrogenERBB2 protein, humanErb-b2 Receptor Tyrosine KinasespalbociclibPiperazinesPyridinesReceptors, Estrogenactivitycyclin-dependent kinase inhibitorsfatiguemetastatic breast cancersleep

Identifiers

PMID39703168
PMCPMC12395256

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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.