{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:41:24Z","timestamp":1791211284451,"version":"4.1.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This prospective observational study investigated the relationship between financial toxicity, symptom burden, disease characteristics and out-of-pocket (OOP) medication use in patients with cancer across 5 Italian institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey assessed financial toxicity, symptom burden and OOP costs sustained by patients with cancer using validated questionnaires (COST, PERSONS). Associations between financial toxicity (COST score), symptom burden (PERSONS score) and clinical variables were explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 211 respondents, mean COST score was 23 (SD 9.1) and 128 (60%) scored\u2005&amp;lt;\u200526, indicating financial toxicity. Symptom burden measured by the PERSONS score was associated with a higher OOP medications use (r\u2005=\u20050.449, P\u2005&amp;lt;\u2005.001) and inversely related to financial toxicity (r\u2005=\u2005\u22120.431; P\u2005&amp;lt;\u2005.001). In our study population, median number of OOP drug was 2 (IQR 1-2), most commonly analgesics and laxatives. There was a significantly worse COST score among patients using OOP analgesic: 19.8 (SD 9.5) vs 25.6 (SD 7.9), P\u2005&amp;lt;\u2005.001 and laxatives: 19.2 (SD 8.2) vs 24.4 [(SD 9.1), P\u2005&amp;lt;\u2005.00]. Overall, OOP drugs were linked to higher symptom burden (P\u2005&amp;lt;\u2005.001) and financial toxicity (P\u2005&amp;lt;\u2005.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The severity of symptoms and their management with OOP medications was significantly associated with patients\u2019 financial toxicity. These findings highlight the importance of integrating financial toxicity assessment into routine cancer care to optimize patient outcomes and well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf131","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T08:08:25Z","timestamp":1747210105000},"source":"Crossref","is-referenced-by-count":11,"title":["The financial toll of cancer: uncovering the links between financial toxicity and symptom burden"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4734-7541","authenticated-orcid":false,"given":"Marco","family":"Filetti","sequence":"first","affiliation":[{"name":"Phase 1 Unit, Fondazione Policlinico Universitario A. 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Gemelli, IRCCS , 00168 Rome,","place":["Italy"]},{"name":"Division of Cancer, Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital , London W12 0HS,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Gentile","sequence":"additional","affiliation":[{"name":"Medical Oncology Unit B, Department of Radiology, Oncology and Pathology, Policlinico Umberto I, Sapienza University of Rome , 00161 Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Toccaceli","sequence":"additional","affiliation":[{"name":"Hospice Care Unit, USL Umbria 1 , 06126 Perugia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guglielmo","family":"Fumi","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera S. Maria S.C. Oncologia , 05100 Terni,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Vacca","sequence":"additional","affiliation":[{"name":"Palliative Care Unit, Ospedale Sirai, Carbonia, ASSL 09013\u00a0 Carbonia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Colpani","sequence":"additional","affiliation":[{"name":"Tuscany Tumors Association, Home Care Service , 50132 Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Ravoni","sequence":"additional","affiliation":[{"name":"Tuscany Tumors Association, Home Care Service , 50132 Florence,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Mazzuca","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sapienza University, Medical Oncology Unit, Azienda Ospedaliera , 00189 Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Daniele","sequence":"additional","affiliation":[{"name":"Phase 1 Unit, Fondazione Policlinico Universitario A. 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