A single item for overall side effect impact: Association with clinician-reported adverse events and global health
Year: 2026
Type: article
Abstract: BACKGROUND: There is growing recognition of the importance of patient-reported tolerability in complementing traditional clinician-reported safety evaluation of cancer therapies. Recent regulatory guidance listed the evaluation of overall side effect impact as a core patient-reported outcome in oncology clinical trials. A single item ('GP5') that asks about side effect bother is included in the Functional Assessment of Chronic Illness Therapy and has been used to capture overall side effect impact. This paper sought to expand the evidence base for GP5 by examining its association with clinician-reported treatment-emergent adverse events and patient-reported global health. METHODS: We examined six commercial cancer clinical trials that collected GP5. The patient population was drawn from the safety population and the analysis focused on the first on-treatment assessment. Clinician-reported adverse events were classified as symptomatic if such adverse events were considered amenable to patient self-reporting (e.g. nausea). Chi-square tests and Pearson's correlation were used to examine associations. We considered adverse event grade and frequency, both for symptomatic adverse events and any type of adverse events. Global health was measured using the visual analogue scale of the EuroQol-5 Dimensions-3 Levels measure. 'Moderate-severe' bother was characterised as scores of 2-4 on a 0-4 point scale for GP5, and 'severe' bother was characterised as scores of 3-4. Analyses were conducted separately for each trial. RESULTS: Data from 3,557 patients were included. Across the trials, most (71.7%-94.2%) patients had an adverse event of some kind, but fewer (17.1%-44.4%) had an adverse event of grade 3 or higher. In general, fewer than 50% of patients (20.6%-44.2%) reported moderate-severe bother and 5.8%-17.% reported severe bother. There were consistent, albeit not always statistically significant, associations between GP5 and adverse events, and GP5/global health correlations ranged from -0.17 to -0.41. DISCUSSION: GP5 is associated with both clinician- and patient-reported symptoms, suggesting its validity and usefulness as part of comprehensive tolerability assessment of cancer trials.
Source: Clinical Trials
Authors: Jessica Roydhouse, Anne Zola, Monique Breslin, Ethan Basch, Melanie Calvert, David Cella, Mary Lou Smith, Gita Thanarajasingam, John Devin Peipert
Institutions: University of Tasmania, Menzies Institute for Medical Research, Northwestern University, University of North Carolina at Chapel Hill, UNC Lineberger Comprehensive Cancer Center, National Institute for Health and Care Research, NIHR Birmingham Biomedical Research Centre, University of Birmingham, Research Advocacy Network, Mayo Clinic
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Health and Human Services, Prostate Cancer Foundation, Pfizer, Gilead Sciences, Movember Foundation, LifeArc, Ionis Pharmaceuticals, UK Research and Innovation, National Institute for Health and Care Research, Prostate Cancer Foundation of Australia, EuroQol Research Foundation, U.S. Food and Drug Administration, Genentech, Cancer Council Tasmania, European Regional Development Fund, Birmingham Biomedical Research Centre, National Institute for Health Research Applied Research Collaboration West, National Cancer Institute, Center for Drug Evaluation and Research
Awards: G3042497558, G8155618876, G8634071215
OpenAlex ID: W7119009460
