{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T10:41:27Z","timestamp":1792320087998,"version":"4.4.0"},"reference-count":54,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Integr Cancer Ther"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Cancer-related fatigue (CRF) is one of the most debilitating symptoms experienced by cancer patients, with a multifactorial etiology involving inflammatory, metabolic, neuroendocrine, and psychological mechanisms. As pharmacological treatments for CRF remain limited and often ineffective, interest has grown in complementary approaches, including the use of Amazonian and related plant extracts. Plant extracts contain various bioactive compounds with multiple pharmacological activities that may be beneficial in addressing complex multifactorial symptoms such as CRF. Purpose: This narrative review evaluates the clinical and mechanistic evidence surrounding the use of two Amazonian plants\u2014Paullinia cupana (guaran\u00e1) and Uncaria tomentosa (cat\u2019s claw)\u2014and one Asian-origin plant naturalized in the Brazilian Amazon\u2014Zingiber zerumbet (bitter ginger)\u2014for the management of CRF. Major Findings: We discuss their phytochemical profiles, proposed biological effects, and the findings of preliminary clinical studies. A notable limitation of the available evidence is that ten of the twelve clinical studies reviewed originate from the author\u2019s home institution (Faculdade de Medicina da Funda\u00e7\u00e3o ABC), raising important questions about generalizability that future multicenter trials should address. Although preliminary results suggest potential benefits in CRF symptom control and quality of life, methodological limitations and heterogeneity across studies warrant caution. Importantly, guaran\u00e1 was associated with worsening outcomes in patients with head and neck cancer undergoing concurrent chemoradiotherapy, underscoring that treatment-type-specific safety must be carefully considered before clinical use. Conclusions: Further well-powered, placebo-controlled, multicenter trials are essential to validate these findings and support clinical integration.<\/jats:p>","DOI":"10.1177\/15347354261498229","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:43:23Z","timestamp":1792068203000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Amazonian and Related Phytotherapy for Cancer-Related Fatigue: A Narrative Review of Clinical and Mechanistic Evidence"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-824X","authenticated-orcid":false,"given":"Auro","family":"del Giglio","sequence":"first","affiliation":[{"name":"ABC Foundation School of Medicine (Faculdade de Medicina da Funda\u00e7\u00e3o ABC)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq458"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.3897\/folmed.62.e50517"},{"issue":"9","key":"e_1_3_4_4_2","first-page":"161","article-title":"Cancer-related fatigue: epidemiology, pathogenesis, diagnosis, and treatment","volume":"109","author":"Horneber M","year":"2012","unstructured":"Horneber M, Fischer I, Dimeo F, R\u00fcffer JU, Weis J. 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