Cancer-related fatigue research at the National Institutes of Health (NIH) from 2015-2024.

Abstract

e24059 Background: Cancer-related fatigue (CRF) is a highly prevalent symptom in cancer patients, significantly impacting quality of life. CRF can result from both cancer and its treatment. There is a strong need for improved management of CRF, as well as a deeper understanding of its underlying mechanisms. In this portfolio analysis, we provide an overview of NIH-funded research over 10 years and discuss areas for growth. Methods: We queried the NIH iSearch database for grants funded by NIH between 2015 and 2024, using a keyword search, and screened results to select for studies that characterize, prevent, measure, or treat CRF. We extracted data on grant characteristics, study design, study samples, and outcomes. We also retrieved information from ClinicalTrials.gov. Results: Our initial search identified 737 grants; further screening resulted in 170 CRF grants. The majority of these studies were funded by the National Cancer Institute (70%). Studies focused largely on clinical patient populations (99%), with only two utilizing animal models. Among the clinical studies, breast cancer (42%), hematologic cancer (21%) and prostate cancer (14%) patients were the most represented patient populations. Sixteen percent of studies were agnostic to cancer diagnosis. Ten percent of the studies focused on patients with advanced cancers. Nearly an equal number of grants studied CRF in pediatric patients (9%) and older adults (8%). Most of the clinical studies were interventional studies (67%), followed by longitudinal studies (24%). CRF was measured through patient-reported outcomes in most studies (97%); several studies also used performance-based measures (4%). Interventional studies primarily focused on lifestyle interventions (80%), followed by devices (12%) and pharmacological interventions (8%). Common lifestyle interventions included exercise (29%), behavioral therapy (22%), or psychological, physical, or combined approaches (15%). Only 3% of the studies focused on diet as an intervention. Forty-seven studies were listed as completed. Among those, 51% had publications with trial results; 9 studies (19%) reported the intervention had a significant effect on CRF measurements, while 8 (24%) studies reported negative findings regarding CRF. Conclusions: Our analysis demonstrates that NIH has invested in many clinical studies related to CRF over 10 years. However, few have examined the underlying mechanisms of CRF in preclinical models. Among the interventional studies, lifestyle interventions, such as exercise, are well-represented in this portfolio analysis. In contrast, there are very few studies focusing on pharmacological agents for CRF. This could be attributed to the need for more mechanistic studies in CRF. Finally, while many of these studies are still ongoing, several studies reported positive findings from their clinical trials, which could be considered for future Phase 3 trials.