{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:59:55Z","timestamp":1788451195764,"version":"build-2803163510"},"reference-count":68,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951525101375_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Despite the high frequency and severity of fatigue among patients with advanced cancer receiving immunotherapy, there are limited treatment options available. The aim of the study was to explore the effects of the methylphenidate (MP) with standardized physical activity (PA) on cancer related fatigue (CRF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101375_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this pilot study, patients with advanced cancer with clinically significant CRF (&lt;34 on Functional Assessment of Cancer Illness Therapy \u2013 fatigue scale, FACIT-F), on anti-PD1 immunotherapy were eligible. Patients were randomized to standardized PA with either patient-controlled MP 5\u00a0mg (MP\u00a0+\u00a0PA arm) or matching Placebo (Pl\u00a0+\u00a0PA arm) twice daily for 14\u00a0days. The primary outcome was the change in the FACIT-F score. Secondary outcomes included changes in fatigue dimensions (Multidimensional Fatigue Symptom Inventory-Short Form (MSFI-SF), Functional Assessment of Cancer Therapy \u2013 General (FACT-G), Patient-Reported Outcome Measurement Information System-Fatigue (PROMIS-F), and hospital anxiety and Depression Scale (HADS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101375_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 40 randomized patients, 34 were evaluable. The FACIT-F scores significantly improved in both the arms with mean (SD) change, effect size (ES) of 11(14), 0.87(\n                      <jats:italic>P &lt;<\/jats:italic>\n                      .001); and 9(12), 0.74(\n                      <jats:italic>P =<\/jats:italic>\n                      \u00a0.04) in MP\u00a0+\u00a0PA, and Pl\u00a0+\u00a0PA arms respectively. We also found significant improvements in PROMIS-F, ES\u00a0\u2212\u00a01.05(\n                      <jats:italic>P =<\/jats:italic>\n                      \u00a0.003), MFSI-SF(global), ES\u00a0\u2212\u00a01.32(\n                      <jats:italic>P &lt;<\/jats:italic>\n                      .001), and HADS-depression, ES\u00a0\u2212\u00a00.92(\n                      <jats:italic>P =<\/jats:italic>\n                      \u00a0.004) in the MP\u00a0+\u00a0PA arm; There were no significant differences in adverse events between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101375_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>Our preliminary study found MP\u00a0+\u00a0PA was associated with significant improvement in CRF scores. The fatigue dimensions and depression scores significantly improved in the MP\u00a0+\u00a0PA arm. Further comparative studies using MP\u00a0+\u00a0PA for CRF are justified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951525101375","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T04:27:40Z","timestamp":1766377660000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Managing fatigue with methylphenidate and physical activity during cancer immunotherapy treatment"],"prefix":"10.1017","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2910-8141","authenticated-orcid":false,"given":"Sriram","family":"Yennurajalingam","sequence":"first","affiliation":[{"name":"University of Texas MD Anderson Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan","family":"Fellman","sequence":"additional","affiliation":[{"name":"The University of Texas MD Anderson Cancer 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