Cognitive disfunctions in women with breast cancer treated with adjuvant chemotherapy: A preliminary report

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20742-e20742
Author(s):  
D. Gercovich ◽  
H. Hirsch ◽  
P. Lopez ◽  
N. Gercovich ◽  
L. Vázquez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Adjuvant Chemotherapy ◽  
Breast Carcinoma ◽  
Cognitive Skills ◽  
Small Sample ◽  
Anxiety And Depression ◽  
Adult Women ◽  
Cognitive Domains ◽  
The Impact

e20742 Background: Recent studies suggest that women diagnosed with breast cancer and treated with adjuvant chemotherapy may suffer cognitive deterioration. These studies, however, present a number of limitations including a small sample of patients, retrospective evaluation of cognitive skills, lack of cognitive-function measurements previous to the chemotherapy and a lack of evaluation of psycho-pathological factors that could potentially influence on the cognitive function of the subjects. The aim of this study is to present the preliminary results of a prospective study about the impact of conventional adjuvant chemotherapy on a series of cognitive domains in adult women diagnosed with breast carcinoma, monitoring frequent psycho-pathological variables such as anxiety and depression. Methods: The present is a cohort, observational study. It includes patients with a diagnosis of stage I and II breast carcinoma, treated with standard chemotherapy and able to give their consent. The protocol has 3 stages of evaluation. First evaluation: a basal measurement between diagnosis and the first chemotherapy course. The second and third evaluations are done at 8 and 14 months respectively after the first one. Each patient has been studied using a neuro-psychological battery of 17 different tests which evaluate the following cognitive domains: global cognitive functioning, intelligence, memory, language and executive functions. The levels of anxiety and depression were studied simultaneously. Further tests will be done for related samples, so as to compare changes within a group. Results: Up to date 14, patients have completed the basal battery of tests. We expect to find differences in the cognitive functions of the patients treated with adjuvant chemotherapy. The aforementioned differences will be controlled with psycho-pathological measurements. Conclusions: The present study will allow us to evaluate in a prospective and exhaustive way cognitive deficiencies in women with breast carcinoma treated with adjuvant chemotherapy. In addition, the use of psycho-pathological instruments will allow monitoring and understanding the neuro-psychological results in a more reliable way. No significant financial relationships to disclose.

The effect of androgen deprivation therapy (ADT) on cognition in men with prostate cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14626-14626
Author(s):  
Z. Allibhai ◽  
S. M. Alibhai
Keyword(s):  
Prostate Cancer ◽  
Cognitive Function ◽  
English Language ◽  
The Elderly ◽  
Small Sample ◽  
Cognitive Domain ◽  
Cognitive Domains ◽  
Medline Search ◽  
The Impact

14626 Background: ADT plays a central role in the management of prostate cancer. However, there is emerging evidence that ADT use may adversely affect cognition. Given the long natural history of prostate cancer and the elderly population it predominantly affects, this may be an important survivorship issue in this population. Methods: We performed a MEDLINE search of English-language literature from 1966 to December 2005 and identified eight prospective studies that evaluated the effect of ADT on cognition and one study that investigated the effect of therapy on the cognition of patients receiving ADT. Due to differences in study design and outcomes, studies could not be combined meta-analytically. Results: Studies were small, ranging from 19–82 patients. ADT was used in the neoadjuvant setting in 2 studies, a neoadjuvant or adjuvant setting in 1 study, and in a palliative setting for high-risk disease in 5 studies. Controls were featured in 4 studies. Follow-up ranged from 6 to 13 months. A variety of cognitive domains were assessed (using traditional and computer-based neuropsychological tasks). Whereas 4 studies found worsening in one or more domains in patients over time, 4 studies showed either no worsening or improvement in one or more cognitive domains after ADT was instituted. No cognitive domain was consistently affected by ADT. Three of the studies included follow-up 3 months after ADT was stopped and all 3 showed at least some improvement in cognitive function. Short-term supplementation with estradiol did not improve cognitive function in 1 study. There were fundamental differences across studies in terms of patient populations, cognitive domains tested and specific tests used, and type of ADT. Other important limitations included small sample sizes, limited follow-up, and practice effects. Conclusions: The impact of ADT on cognitive function and its potential reversibility are unclear, and further studies are needed. In the meantime, clinicians and patients should continue to carefully weigh the potential benefits and risks of ADT when making treatment decisions. No significant financial relationships to disclose.

scholarly journals An Evaluation of DNA Methyltransferase 1 (DNMT1) Single Nucleotide Polymorphisms and Chemotherapy-Associated Cognitive Impairment: A Prospective, Longitudinal Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alexandre Chan ◽  
Angie Yeo ◽  
Maung Shwe ◽  
Chia Jie Tan ◽  
Koon Mian Foo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cancer Patients ◽  
Dna Methyltransferase ◽  
Dna Methyltransferases ◽  
Breast Cancer Patients ◽  
Prospective Longitudinal Study ◽  
Cognitive Domains ◽  
Prospective Longitudinal

Abstract Strong evidence suggests that genetic variations in DNA methyltransferases (DNMTs) may alter the downstream expression and DNA methylation patterns of neuronal genes and influence cognition. This study investigates the association between a DNMT1 polymorphism, rs2162560, and chemotherapy-associated cognitive impairment (CACI) in a cohort of breast cancer patients. This is a prospective, longitudinal cohort study. From 2011 to 2017, 351 early-stage breast cancer patients receiving chemotherapy were assessed at baseline, the midpoint, and the end of chemotherapy. DNA was extracted from whole blood, and genotyping was performed using Sanger sequencing. Patients’ self-perceived cognitive function and cognitive performance were assessed at three different time points using FACT-Cog (v.3) and a neuropsychological battery, respectively. The association between DNMT1 rs2162560 and cognitive function was evaluated using logistic regression analyses. Overall, 33.3% of the patients reported impairment relative to baseline in one or more cognitive domains. Cognitive impairment was observed in various objective cognitive domains, with incidences ranging from 7.2% to 36.9%. The DNMT1 rs2162560 A allele was observed in 21.8% of patients and this was associated with lower odds of self-reported cognitive decline in the concentration (OR = 0.45, 95% CI: 0.25–0.82, P = 0.01) and functional interference (OR = 0.48, 95% CI: 0.24–0.95, P = 0.03) domains. No significant association was observed between DNMT1 rs2162560 and objective cognitive impairment. This is the first study to show a significant association between the DNMT1 rs2162560 polymorphism and CACI. Our data suggest that epigenetic processes could contribute to CACI, and further studies are needed to validate these findings.

P237 The impact of body composition change on neo-adjuvant chemotherapy for breast cancer patients

The Breast ◽  
2015 ◽  
Vol 24 ◽  
pp. S106-S107
Author(s):  
T. Iwase ◽  
T. Sangai ◽  
E. Ishigami ◽  
J. Sakakibara ◽  
K. Fujisaki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Composition Change ◽  
Breast Cancer Patients ◽  
Body Composition Change ◽  
Neo Adjuvant Chemotherapy ◽  
The Impact

scholarly journals The impact of Oncotype DX testing on adjuvant chemotherapy decision making in 1–3 node positive breast cancer

2021 ◽  
Author(s):  
Yogeshkumar Malam ◽  
Mohamed Rabie ◽  
Konstantinos Geropantas ◽  
Susanna Alexander ◽  
Simon Pain ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Adjuvant Chemotherapy ◽  
Oncotype Dx ◽  
Node Positive ◽  
The Impact ◽  
Positive Breast Cancer

Impact of race on biomarker testing among HER2- advanced breast cancer (ABC) patients (pts) in the United States: Results from a real-world study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10598-10598
Author(s):  
Reshma L. Mahtani ◽  
Alexander Niyazov ◽  
Katie Lewis ◽  
Lucy Massey ◽  
Alex Rider ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Targeted Therapies ◽  
Small Sample Size ◽  
The United States ◽  
Small Sample ◽  
Access To Treatment ◽  
History Of ◽  
Biomarker Testing ◽  
Abstract Data ◽  
The Impact

10598 Background: African Americans (AA) have the highest breast cancer (BC) mortality rate. Access to treatment is a known contributing factor. In the past 4 years, several targeted therapies for HER2- BC have become available which require testing for specific biomarkers. This study assessed the impact of race on biomarker testing rates in HER2- ABC pts receiving treatment in the US. Methods: Oncologists were recruited to abstract data from medical charts for the next 8-10 pts receiving treatment with HER2- ABC during Sept 2019-Apr 2020. Pts records were stratified by race and categorized into 3 mutually exclusive cohorts [White/Caucasian (White), AA, Other]. The other race cohort was excluded from this analysis due to small sample size. Differences in pt demographics/clinical characteristics were analyzed via Fisher’s exact tests. Testing rates for actionable biomarkers (i.e. BRCA1/2, PIK3CA, PD-L1) were compared between White and AA pts utilizing logistic regressions controlling for age, known family history of a BRCA-related cancer, hormone receptor (HR) status and practice setting (academic vs. community). Further analyses by age will be presented. Results: This analysis included 378 pts records, provided by 40 oncologists. Mean age was 64 years; 77% had HR+/HER2- ABC; 20% had advanced triple negative breast cancer (TNBC), 3% had ABC with an unknown HR status. Compared to White pts, AA pts were significantly more likely to have advanced TNBC (27% vs. 18%, p<0.05). Compared to White pts, AA pts had significantly lower BRCA1/2 mutation (mut) testing rates (Table). Numerically lower rates of PIK3CAmut and PD-L1 testing were observed among AA pts (Table). BRCA1/2mut positivity rate (germline [g] and/or somatic [s]) was higher among AA vs. White pts (30% vs. 22%). Positivity rate for PIK3CAmut was lower for AA vs. White pts (8% vs. 11%). Conclusions: A higher than expected BRCA1/2mut positivity rate was observed than previously reported in the literature. This is likely because this analysis included s BRCA1/2mut and represented a high risk pt population. Across all biomarkers assessed, AA pts had lower testing rates than White pts. This suggests racial disparities in testing rates of actionable biomarkers. Consistent with guidelines, and with the increased availability of targeted therapies, focused efforts should be developed to increase biomarker testing in AA pts. Funding: Pfizer Biomarker Testing Rates by Race.[Table: see text]

The impact of primary irradiation treatment of localized breast cancer on the ability to administer systemic adjuvant chemotherapy.

1984 ◽  
Vol 2 (1) ◽  
pp. 21-27 ◽  
Author(s):  
M E Lippman ◽  
A S Lichter ◽  
B K Edwards ◽  
C R Gorrell ◽  
T d'Angelo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Local Therapy ◽  
Irradiation Treatment ◽  
Primary Irradiation ◽  
Drug Doses ◽  
Chemotherapy Dose ◽  
The Impact ◽  
To Receive ◽  
Primary Management

The impact of primary irradiation of localized breast cancer on the ability to administer Adriamycin-cytoxan adjuvant chemotherapy to patients with stage II breast cancer was examined. Patients were prospectively randomized to receive either irradiation or mastectomy as local therapy and did not differ with respect to other prognostic variables that might influence tolerance to chemotherapy. All of the patients received chemotherapy dose escalations (or reductions) until maximal tolerated drug doses were established. Patients receiving irradiation had minimally greater myelosuppression which was nearly totally explainable by lymphopenia. Irradiated patients required dose reduction nearly twice as often as mastectomy patients although commonly their dose could be reescalated. Patients managed with radiotherapy received slightly less drug than patients treated with mastectomy when treated to an identical degree of bone marrow suppression. The primary management of breast cancer by irradiation does not induce substantial changes in the ability of patients to tolerate adjuvant chemotherapy.

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