# Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials Source: https://onco.cc/key-papers/paper-di-maio-j-clin-oncol/ OnCo record `paper-di-maio-j-clin-oncol` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence. ## TL;DR Paper cited by one bottleneck page and 15 idea pages, indexed on Europe PMC as PubMed record 25624439 and published in Journal of Clinical Oncology; the citing pages link this DOI, which is how the record was matched. ## Summary Purpose: Information about symptomatic toxicities of anticancer treatments is not based on direct report by patients, but rather on reports by clinicians in trials. Given the potential for under-reporting, our aim was to compare reporting by patients and physicians of six toxicities (anorexia, nausea, vomiting, constipation, diarrhea, and hair loss) within three randomized trials. Patients and methods: In one trial, elderly patients with breast cancer received adjuvant chemotherapy; in two trials, patients with advanced non-small-cell lung cancer received first-line treatment. Toxicity was prospectively collected by investigators (graded by National Cancer Institute Common Toxicity Criteria [version 2.0] or Common Terminology Criteria for Adverse Events [version 3]). At the end of each cycle, patients completed the European Organisation for Research and Treatment of Cancer quality-of-life questionnaires, including toxicity-related symptom items. Possible answers were "not at all," "a little," "quite a bit," and "very much." Analysis was limited to the first three cycles. For each toxicity, agreement between patients and physicians and under-reporting by physicians (ie, toxicity reported by patients but not reported by physicians) were calculated. Results: Overall, 1,090 patients (2,482 cycles) were included. Agreement between patients and physicians was low for all toxicities. Toxicity rates reported by physicians were always lower than those reported by patients. For patients who reported toxicity (any severity), under-reporting by physicians ranged from 40.7% to 74.4%. Examining only patients who reported "very much" toxicity, under-reporting by physicians ranged from 13.0% to 50.0%. Conclusion: Subjective toxicities are at high risk of under-reporting by physicians, even when prospectively collected within randomized trials. This strongly supports the incorporation of patient-reported outcomes into toxicity reporting in clinical trials. Indexed on Europe PMC as PubMed record 25624439 (DOI 10.1200/jco.2014.57.9334). Matched by DOI alone: one bottleneck page and 15 idea pages cite this DOI among their external links (the pages are listed under Related), and this page was written so that the citation resolves inside OnCo. No figure has been checked by an editor. ## Fields - Kind: Key paper - Last checked: 2026-09-22 - Tags: europepmc-ingest - Journal: Journal of Clinical Oncology - Year: 2015 - DOI: 10.1200/jco.2014.57.9334 - Authors: Di Maio M, Gallo C, Leighl NB, et al. - What it means: One bottleneck page and 15 idea pages on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand. - Caveats: Matched to the citing OnCo records by DOI alone; the summary reproduces the Europe PMC abstract and no figure has been verified against the full paper. ## Sources - J Clin Oncol 2015: https://doi.org/10.1200/jco.2014.57.9334 - PubMed: https://pubmed.ncbi.nlm.nih.gov/25624439/ - Europe PMC: https://europepmc.org/article/MED/25624439 ## Connected records - bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/) - ideas: [A lifelong late-effects registry linked to every treatment for adult survivors](https://onco.cc/ideas/idea-moon-adult-late-effects-registry/), [A permanent platform trial for supportive-care interventions inside cooperative groups](https://onco.cc/ideas/idea-moon-supportive-care-platform-trial/), [A prevention programme for chemotherapy nerve damage: SARM1 inhibitors, cooling and compression](https://onco.cc/ideas/idea-moon-neuropathy-prevention-programme/), [Biomarker-guided cardioprotection for everyone on cardiotoxic cancer therapy](https://onco.cc/ideas/idea-moon-cardioprotection-by-default/), [Fertility preservation offered and funded by default before gonadotoxic treatment](https://onco.cc/ideas/idea-moon-fertility-preservation-default/), [Fund scalp cooling and hair-preserving measures for every alopecia-inducing regimen](https://onco.cc/ideas/idea-moon-hair-preservation-for-all/), [Measure and treat chemo brain with objective digital cognitive testing](https://onco.cc/ideas/idea-moon-cognitive-toxicity-programme/), [Oncology hospital-at-home with remote monitoring for toxicity](https://onco.cc/ideas/idea-moon-oncology-hospital-at-home/), [Payers price drugs on quality-adjusted benefit, so toxicity costs the manufacturer](https://onco.cc/ideas/idea-moon-quality-adjusted-pricing/), [Photobiomodulation and a taste and swallowing programme for mouth and throat toxicity](https://onco.cc/ideas/idea-moon-mucositis-taste-programme/), [Predict immune side-effects before they happen and pre-empt them](https://onco.cc/ideas/idea-moon-irae-prediction-and-prevention/), [Protect hearing from cisplatin in adults as we now do in children](https://onco.cc/ideas/idea-moon-hearing-protection-cisplatin/), [Quality-adjusted survival reported in every trial publication and label](https://onco.cc/ideas/idea-moon-quality-adjusted-survival-standard/), [Sexual health assessed and treated as a standard toxicity domain](https://onco.cc/ideas/idea-moon-sexual-health-as-toxicity-domain/), [Tolerability as a co-primary endpoint with its own label claim](https://onco.cc/ideas/idea-moon-toxicity-first-endpoints/) - journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/) --- JSON: https://onco.cc/api/v1/entities/paper-di-maio-j-clin-oncol.json