Abstract
In this review on the status of tolerability in pediatric oncology, the authors address the relevance and meaning of this important concept and offer a definition to represent treatment tolerability experiences of pediatric, adolescent, and young adult oncology patients. The authors acknowledge the incomplete progress of tolerability research in pediatric oncology clinical trials while describing the recent advances in validating relevant measures and embedding these in pediatric oncology clinical trials to document the symptom burden of specific cancer treatments. They advocate for the consistent use of three voices-patient, caregiver, and clinician-in pediatric oncology to achieve accurate and comprehensive estimates of treatment tolerability while recognizing that a primary voice may be necessary to match the main aim or goal of the proposed research. Future steps include establishing the validity of tolerability measures and methods in patients younger than 7 years and a careful examination of tolerability issues into survivorship.