e19598 Background: Apathy, or lack of motivation, has been little studied in cancer patients. Because interventions for Cancer-Related Fatigue (CRF) often include behavioral change and involve commitment to treatment, patient apathy may be detrimental to outcome success. We conducted an observational study in our CRF Clinic and report on 110 patients evaluated for apathy. Our objectives were to investigate associations between apathy and fatigue-related symptoms and determine if clinically apathetic patients differed from the non-apathetic in symptom burden. Methods: New CRF patients were evaluated for apathy using the Apathy Evaluation Scale, Clinician Version (AES-C) as primary outcome measure. The AES-C provides a continuous apathy score (range 18-72); scores can also be used to categorize patients as apathetic or non-apathetic (AES-C ≥ 38 reflects clinically significant apathy). To explore apathy and fatigue symptom associations, AES-C scores were correlated (Spearman's rho) with five symptoms commonly experienced by CRF patients (fatigue, pain, depression, anxiety, sleep disturbance), and level of symptom burden was compared (Mann-Whitney U) across apathetic vs. non-apathetic patients. Results: Of the 110 new CRF patients evaluated for apathy, median age was 60 years (range 24-92), 69% (n=76) were female, 76% (n=84) white, and 68% (n=75) married. The most frequent cancer diagnoses were breast (35%, n=38) and leukemia/lymphoma/myeloma (18%, n=20). Median apathy score was 26 (range 18-61), with 22% (n=24) identified as clinically apathetic. Apathy was statistically significantly (p<.05) associated with fatigue, depression, and anxiety (rho=.34, .48, .30, respectively). Apathetic patient symptom burden was statistically significantly (p<.05) greater than the non-apathetic for fatigue (BFI 7.2 vs. 5.6), depression (BDI-II 22.4 vs. 12.6), and anxiety (BAI 16.4 vs. 11.0). Conclusions: Patient apathy is associated with fatigue, depression, and anxiety, while patients identified as apathetic experience increased symptomatic burden. Thus, apathy may undermine patient CRF treatment objectives. Future investigations include determining factors involved in the development of patient apathy and identifying methods to reduce or eliminate it. No significant financial relationships to disclose.