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Cancer-related fatigue (CRF) is a common, burdensome, debilitating subjective sense of tiredness or exhaustion in patients with cancer. The pathogenesis is assumed to be multifactorial with CRF being a final common pathway. Among other things, treatment with immune checkpoint inhibitors (ICI) is also associated with CRF. However, the toxic adverse events of ICI are not inevitably the only cause for CRF. Therefore, the diagnostic procedure should address other possible influencing factors, e.g., somatic, mental, cognitive, and psychosocial causes. To manage CRF evidence-based, causal, and symptomatic therapies are available. The key condition to manage CRF is active listening and shared decision making (SDM) with the goal to select those interventions from the broad spectrum of therapies that are best suited for the particular patient and their life circumstances. Providing information about ICI and CRF to reassure patients is already an effective intervention., (© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2021.)

Ten patients with advanced renal carcinoma were treated by ifosfamide (50-60 mg/kd/day x 5 days). The treatment was repeated every 4 weeks and continued until progression appeared. Two patients came into partial remission, two had subjective improvement, and six did not respond. Seven patients developed acute psychopathological symptoms during the first ifosfamide-cycle. Five patients had visual and paranoid hallucinations, four patients were completely confused. Follow-up for up to 10 weeks showed a persisting organic brain syndrome in five patients.

In 361 Sprague-Dawley rats autochthonous colorectal carcinomas were induced by intrarectal application of the carcinogen AMMN. Tumor-bearing animals were treated with a synthetic thioether-lysophospholipid (TLP) derivative and in combination chemotherapy with 5-fluorouracil (5-FU) and carmustine (BCNU). There was no difference in the survival time of treated and untreated animals. The median large-bowel tumor weight was significantly lower in the TLP/5-FU and TLP/5-FU/BCNU combination therapy groups than in the control groups. Transient hepatotoxicity was observed in the high-dosage (50 mg/kg body weight twice weekly) TLP group. This study confirmed the relative resistance of AMMN-induced colorectal carcinomas to antineoplastic treatment.