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Chemotherapy-Induced Cognitive Impairment and Its Long-Term Development in Patients With Breast Cancer
TAKE-HOME MESSAGE
- This prospective longitudinal study (CICARO) explored the long-term impact of chemotherapy-induced cognitive impairment on the quality of life of patients with breast cancer. The authors reported that cognitive function, especially memory, and quality of life significantly declined after chemotherapy but largely recovered to baseline levels within 2 to 3 years.
- The study findings also suggest that serum neurodegenerative markers are correlated with cognitive decline; however, further research is needed to validate predictive biomarkers.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Chemotherapy-induced cognitive impairment (CICI) is a well-recognized side effect of breast cancer treatment. However, prospective long-term evaluations of CICI using standardized neuropsychological tests are scarce.
PATIENTS AND METHODS
This prospective longitudinal cohort study investigated cognitive dysfunction and its impact on quality of life and everyday functioning in patients with breast cancer receiving first-line chemotherapy compared to patients with breast cancer without chemotherapy. Assessment occurred prior to chemotherapy, postchemotherapy (median 6 months), and 2-3 years later. We used standardized neuropsychological tests, questionnaires, and scales to assess patients' quality of life and functioning. Additionally, serum analysis for neurodegenerative markers and autoantibodies was conducted.
RESULTS
We included n = 53 patients. Overall cognitive function declined statistically significantly (P = .046) postchemotherapy compared to control patients, mostly driven by a reduced figural memory (P = .011). Patients who received chemotherapy showed a greater reduction in quality of life (increased fatigue symptoms, P = .023; reduced Karnofsky index, P < .001); however, without a statistically significant effect on cognitive decline. The neurodegenerative markers Neurofilament light chain (NfL) and phosphorylated Neurofilament heavy chain (pNfH) increased statistically significantly (P < .001) postchemotherapy and pNfH correlated with overall cognitive function. After 2-3 years, both cognitive performance and quality of life were comparable between chemotherapy-treated and control patients.
CONCLUSION
Our findings suggest that chemotherapy statistically significantly contributes to overall cognitive dysfunction in patients with breast cancer, which disappears after 2-3 years, indicating a recovery in both objectively measurable cognitive function and subjective quality of life. Future research should examine larger sample sizes and explore screening indicators, particularly pNfH.
Additional Info
Disclosure statements are available on the authors' profiles:
Chemotherapy-induced cognitive impairment and its long-term development in patients with breast cancer: results from the observational CICARO study
Oncologist 2024 Oct 15;[EPub Ahead of Print], A Kerkmann, C Schinke, A Dordevic, J Kern, N Bangemann, J Finck, JU Blohmer, K Ruprecht, JC Göpfert, C Otto, B Materne, M Endres, W Boehmerle, P HuehnchenFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.