Fatigue is the most commonly reported side effect of any cancer treatments, radiation, or chemotherapy: 90% of cancer patients say that fatigue affects their lives, and 25% say that the fatigue persists even after treatments have ended. Findings from a 1-month study undertaken to determine whether modafinil could combat fatigue following treatment in cancer patients were reported during a poster session by Gary Morrow, MD, a professor of both psychiatry and oncology at the University of Rochester Medical Center in Rochester, New York.

The study involved 54 women who had been treated for breast cancer and were a mean of 23.9 months posttherapy. The patients were asked to take modafinil, 200 mg/day before breakfast.

Prior to enrollment, the women, whose mean age was 54 years, reported a mean score of 6.9 on a fatigue inventory scale where 0 = no impact on quality of life and 10 = "as bad as you can imagine." After one1 month of using modafinil, the mean fatigue score had fallen to 3.7.

Using a 5-point global effectiveness questionnaire, the women were asked to quantify the benefit they achieved from using the drug. The mean score was 5.0, where 0 = no improvement and 7 = a great improvement.

Half of the patients reported fewer sleep disturbances, and half reported less drowsiness. Other factors that showed an improvement were activity (64%), mood (63%), walking ability (63%), normal work ability (66%), relations with other people (66%), and enjoyment of life (61%).

Four women withdrew from the trial prematurely, 3 because of reported agitation and 1 because of an unexpected pregnancy.

According to Dr. Morrow, a larger trial now underway will attempt to demonstrate whether these improvements are real and how lasting they might be.

The study was funded by the National Cancer Institute and Cephalon Pharmaceuticals, maker of Provigil.


[Presentation title: The Positive Effect of the Psychostimulant Modafinil on Fatigue From Cancer That Persists After Treatment is Completed. Abstract 8012]

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