Joint nausea and fatigue profiles during chemotherapy identify patients with a higher symptom burden

Identify subgroups of oncology patients with distinct joint chemotherapy-induced nausea (CIN) AND morning fatigue profiles and distinct joint CIN AND evening fatigue profiles, as well as modifiable and non-modifiable risk factors.

Oncology patients receiving chemotherapy completed self-report questionnaires that provided information on demographic and clinical characteristics, as well as on CIN and morning and evening fatigue. The three symptoms were assessed six times over two cycles of chemotherapy. Joint latent class profile analyses (LCPA) were performed to identify subgroups of patients with distinct joint symptom profiles. Parametric and non-parametric tests were used to evaluate for differences in modifiable and non-modifiable risk factors among the profiles.

Five and four subgroups were identified with distinct joint CIN and morning fatigue and distinct joint CIN and evening fatigue profiles, respectively. Risk factors associated with membership in the worse profiles included younger age, lower annual household income, high comorbidity burden, lower functional status, self-reported diagnosis of depression, and higher levels of neuropsychological and gastrointestinal symptoms.

Across both LCPAs, 60% of the sample reported CIN with occurrence rates that ranged from approximately 30% to 90%. In addition, wide variations were found in both morning and evening fatigue severity scores depending on the distinct profile. These initial findings suggest that CIN co-occurs with both morning and evening fatigue. The co-occurrence of CIN and fatigue may be related to shared biological mechanisms that warrant evaluation in future studies.