Nav: Home

Neurotoxic effects of chemotherapies on cognition in breast cancer survivors

December 03, 2015

Cancer-related cognitive impairment is often referred to as 'chemobrain' and anthracycline-based chemotherapy may have greater negative effects on particular cognitive domains and brain network connections than nonanthracycline-based regimens, according to an article published online by JAMA Oncology.

Chemotherapy for breast cancer is often associated with cognitive problems in patients. However, it is unclear whether certain regimens are associated with greater cognitive difficulties than others.

Shelli R. Kesler, Ph.D., of the University of Texas MD Anderson Cancer Center, Houston, and Douglas W. Blayney, M.D., of the Stanford University School of Medicine, California, compared the effects of anthracycline and nonanthracycline chemotherapy regimens on cognitive status and functional brain connectivity in a small study.

The authors used cognitive tests and imaging data from 62 primary breast cancer survivors (average age nearly 55) who were, on average, more than two years off therapy to examine cognitive status and functional brain connectivity. Of the women, 20 received anthracycline-based chemotherapy as part of their primary treatment, 19 received nonanthracycline regimens and 23 did not receive any chemotherapy.

Women treated with anthracycline-based chemotherapy had lower verbal memory, including immediate recall and delayed recall, compared with the other two groups of women. The anthracycline regimens also were associated with lower default mode brain network connectivity, suggesting a decreased efficiency of information processing, according to the study.

Patient-reported outcomes of cognitive dysfunction and psychological distress were elevated in both groups of women treated with chemotherapy compared with patients treated without chemotherapy, the results indicate.

"These results should be considered preliminary given the study limitations of small sample size and retrospective, cross-sectional design, Larger, prospective studies are needed that include pretreatment and posttreatment assessments so that patients' individual cognitive and neurobiologic trajectories can be evaluated with respect to potential ANTHR [anthracycline]-related neurotoxic effects," the study concludes.

-end-

(JAMA Oncol. Published online Dec. 3, 2015. doi:10.1001/jamaoncol.2015.4333. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: This research was supported by grants from the National Institutes of Health. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Imaging Brain Networks After Cancer and Chemotherapy

"While previous studies have linked chemotherapy and cognitive decline, and a few other studies have linked treatment with differences in brain connectivity, there has been very little research comparing cognitive effects of different types and combinations of chemotherapy because most studies have been underpowered to distinguish these effects. This present study builds on preclinical work and, although modest in power to detect regimen differences, represents an important step forward while underscoring the need for larger studies," write Andrew J. Saykin, Psy.D., of the Indiana University School of Medicine, Indianapolis, and coauthors in a related editorial. (JAMA Oncol. Published online Dec. 3, 2015. doi:10.1001/jamaoncol.2015.4551. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Funding/support disclosures were made. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding author Shelli R. Kesler, Ph.D., call Laura Sussman at 713-745-2457 or email lsussman@mdanderson.org. To contact corresponding editorial author Andrew J. Saykin, Psy.D., call Danielle Sirilla at 317-962-4572 or email dsirilla@iuhealth.org or call Gene Ford at 317-985-8731 or email gford2@iuhealth.org.

The JAMA Network Journals

Related Breast Cancer Articles:

Does MRI plus mammography improve detection of new breast cancer after breast conservation therapy?
A new article published by JAMA Oncology compares outcomes for combined mammography and MRI or ultrasonography screenings for new breast cancers in women who have previously undergone breast conservation surgery and radiotherapy for breast cancer initially diagnosed at 50 or younger.
Blood test offers improved breast cancer detection tool to reduce use of breast biopsy
A Clinical Breast Cancer study demonstrates Videssa Breast can inform better next steps after abnormal mammogram results and potentially reduce biopsies up to 67 percent.
Surgery to remove unaffected breast in early breast cancer increases
The proportion of women in the United States undergoing surgery for early-stage breast cancer who have preventive mastectomy to remove the unaffected breast increased significantly in recent years, particularly among younger women, and varied substantially across states.
Breast cancer patients with dense breast tissue more likely to develop contralateral disease
Breast cancer patients with dense breast tissue have almost a two-fold increased risk of developing disease in the contralateral breast, according to new research from The University of Texas MD Anderson Cancer.
Some early breast cancer patients benefit more from breast conservation than from mastectomy
Breast conserving therapy (BCT) is better than mastectomy for patients with some types of early breast cancer, according to results from the largest study to date, presented at ECC2017.
One-third of breast cancer patients not getting appropriate breast imaging follow-up exam
An annual mammogram is recommended after treatment for breast cancer, but nearly one-third of women diagnosed with breast cancer aren't receiving this follow-up exam, according to new findings presented at the 2016 Annual Clinical Congress of the American College of Surgeons.
Low breast density worsens prognosis in breast cancer
Even though dense breast tissue is a risk factor for breast cancer, very low mammographic breast density is associated with a worse prognosis in breast cancer patients.
Is breast conserving therapy or mastectomy better for early breast cancer?
Young women with early breast cancer face a difficult choice about whether to opt for a mastectomy or breast conserving therapy (BCT).
Breast density and outcomes of supplemental breast cancer screening
In a study appearing in the April 26 issue of JAMA, Elizabeth A.
Full dose radiotherapy to whole breast may not be needed in early breast cancer
Five years after breast-conserving surgery, radiotherapy focused around the tumor bed is as good at preventing recurrence as irradiating the whole breast, with fewer side effects, researchers from the UK have found in the large IMPORT LOW trial.

Best Science Podcasts 2017

We have hand picked the best science podcasts for 2017. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: Radiolab

Oliver Sipple
One morning, Oliver Sipple went out for a walk. A couple hours later, to his own surprise, he saved the life of the President of the United States. But in the days that followed, Sipple's split-second act of heroism turned into a rationale for making his personal life into political opportunity. What happens next makes us wonder what a moment, or a movement, or a whole society can demand of one person. And how much is too much?
Now Playing: TED Radio Hour

Future Consequences
From data collection to gene editing to AI, what we once considered science fiction is now becoming reality. This hour, TED speakers explore the future consequences of our present actions. Guests include designer Anab Jain, futurist Juan Enriquez, biologist Paul Knoepfler, and neuroscientist and philosopher Sam Harris.