{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T19:48:54Z","timestamp":1783021734447,"version":"3.54.6"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Fatigue 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Eighty-eight patients with HR+\u2005HER2\u2212 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\u2005&amp;lt;\u200534), 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Patient-reported fatigue emerged in 21\/88 patients [incidence rate 23.9% (95%CI, 15.4%-34.1%)] within 2.8\u2005\u00b1\u20051.7 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\u2005=.01), but ANC levels on treatment did not (P\u2005=.78). Other pretreatment predictors were long sleep duration (P\u2005=.02) and low physical activity (trend, P\u2005=.07). Treatment-emergent fatigue was associated with objectively measured long sleep duration on treatment (P\u2005=.02), but not other measures (P\u2005\u2265.35).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>One-quarter of patients with HR+\u2005HER2\u2212 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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyae316","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T03:37:52Z","timestamp":1734665872000},"source":"Crossref","is-referenced-by-count":3,"title":["Incidence of patient-reported fatigue developing on palbociclib and endocrine therapy for advanced HR+ HER2\u2212 breast cancer"],"prefix":"10.1093","volume":"30","author":[{"given":"Shadab A","family":"Rahman","sequence":"first","affiliation":[{"name":"Division of Sleep Medicine, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]},{"name":"Division of Sleep and Circadian Disorders, Department of Medicine and Neurology, Brigham and Women\u2019s Hospital , Boston, MA 02115 ,","place":["United States"]},{"name":"Connors Center for Women\u2019s Health and Gender Biology, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke","family":"Poort","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute Department of Psychosocial Oncology and Palliative Care, , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Schrag","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Dana-Farber Cancer Institute , Boston, MA 02115 ,","place":["United States"]},{"name":"Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie C","family":"Tung","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Dana-Farber Cancer Institute , Boston, MA 02115 ,","place":["United 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Hospital, Harvard Medical School Department of Psychiatry, , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elkhansaa","family":"Elguenaoui","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School Department of Psychiatry, , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moira","family":"Nolan","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Harvard Medical School Department of Psychiatry, , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica L","family":"Mayer","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Dana-Farber Cancer Institute , Boston, MA 02115 ,","place":["United States"]},{"name":"Harvard Medical School , Boston, MA 02115 ,","place":["United 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