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Journal of Cancer Survivorship

, Volume 13, Issue 5, pp 673–686 | Cite as

Nicotinic treatment of post-chemotherapy subjective cognitive impairment: a pilot study

  • Jennifer N. VegaEmail author
  • Kimberly M. Albert
  • Ingrid A. Mayer
  • Warren D. Taylor
  • Paul A. Newhouse
Article
  • 75 Downloads

Abstract

Purpose

Persistent chemotherapy-related cognitive impairment (pCRCI) is commonly reported following cancer treatment and negatively affects quality of life; however, there is currently no pharmacological treatment indicated for pCRCI. This pilot study obtained preliminary data regarding the use of transdermal nicotine patches as a therapeutic strategy for women with pCRCI to (1) reduce subjective cognitive complaints and (2) enhance objective cognitive performance in breast, colon, lymphoma, or ovarian cancer survivors with pCRCI.

Methods

Participants were randomized to either placebo (n = 11) or transdermal nicotine (n = 11) for 6 weeks, followed by 2 weeks of treatment withdrawal for a total of 8 weeks. Participants were assessed using both subjective and objective measures of cognitive functioning at five visits before, during, and after treatment.

Results

Over the course of the study, women in both groups improved substantially in severity of self-reported cognitive complaints measured by Functional Assessment of Cancer Therapy-Cognitive Function Perceived Cognitive Impairments regardless of treatment arm. Additionally, objective cognitive performance measures improved in both groups; however, there was no significant difference in improvement between groups.

Conclusions

Due to a large placebo response, we were unable to determine if a drug effect was present. However, we did observe substantial improvement in self-reported cognitive symptoms, likely resulting from factors related to participation in the trial rather than specific drug treatment effects.

Trial registration

The study was registered with clinicaltrials.gov (trial registration: NCT02312943).

Implications for Cancer Survivors

These results suggest that women with pCRCI can exhibit improvement in subjective cognition, with attention paid to symptoms and close follow-up over a short period of time.

Keywords

Chemotherapy-related cognitive impairment Breast cancer Survivorship Cognitive impairment Clinical trial 

Notes

Acknowledgments

We wish to acknowledge the invaluable contributions of our research volunteers for their dedication to clinical research.

Funding

Preparation of this work was supported by 1 R01 AG047992-01A1 to PN, Vanderbilt Institute for Clinical and Translational Research (VICTR) CTSA Grant (UL1TR000445) from the National Center for Advancing Translational Sciences to JNV, K24 MH110598 to WDT, and T32-AG058524 (JNV) and the Vanderbilt Memory & Alzheimer’s Center.

Compliance with ethical standards

Conflict of interest

JN Vega, KM Albert, PA Newhouse, WD Taylor, and Paul A. Newhouse declare no conflicts of interest. IA Mayer has received consultancy/advisory fees from AstraZeneca, Novartis, Genentech, Eli Lilly, Immunomedics, MacroGenics, and GlaxoSmithKline and received research funding from Novartis, Genentech, and Pfizer.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Declaration of Helsinki. This study was approved by the Vanderbilt-Ingram Cancer Center (VICC BRE 1692) and the Vanderbilt University Institutional Review Boards (IRB 141584).

Informed consent

All participants gave written informed consent in accordance with the Declaration of Helsinki.

Supplementary material

11764_2019_786_MOESM1_ESM.pdf (1 mb)
ESM 1 (PDF 1055 kb)

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Center for Cognitive Medicine, Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleUSA
  2. 2.Department of MedicineVanderbilt University Medical Center/Vanderbilt-Ingram Cancer CenterNashvilleUSA
  3. 3.Geriatric Research, Education, and Clinical CenterVeterans Affairs Tennessee Valley Health SystemNashvilleUSA

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