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Impact of taxane-based chemotherapy among older women with breast cancer on cognition and quality of life: a longitudinal pooled analysis

  • Epidemiology
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Abstract

Purpose

Older cancer patients are susceptible to long-term effects of chemotherapy, including cancer-related cognitive decline and impairments to quality of life. Taxane-based chemotherapies are associated with physical declines among older women and may negatively impact cognitive performance. We sought to examine whether changes in objective and subjective measures of cognitive performance and well-being differ among older breast cancer survivors as a function of taxane-based chemotherapy treatment regimens.

Methods

Individual-level data were pooled and harmonized from two large prospective studies of older (greater than 60 years) breast cancer survivors. Assessments were conducted prior to systemic therapy and up to 36 months after. Cognitive performance was assessed with objective (working memory, processing speed, and executive functions) and subjective tests and physical, emotional, and functional well-being were also assessed.

Results

One hundred and sixty-seven (M age = 67.3 years) women with 116 receiving chemotherapy with taxanes and 51 without taxanes contributed data. Declines in subjective cognition for both groups were significant between pre-treatment and 12-month follow-up. Significant improvements were seen on a measure of objective cognition (working memory) from 12 to 36 months. Measures of well-being improved from prior to systemic therapy to 12 months. Longitudinal changes across all measures did not vary as a function of receipt of taxane-based treatment.

Conclusion

Older women who received treatment with taxanes did not have greater declines in cognitive performance or well-being than women receiving other chemotherapy regimens. Despite older cancer survivors being at greater risk for negative outcomes, treatment with taxane-based chemotherapies does not appear to exacerbate these health consequences.

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Data availability

Data are made available upon request.

Code availability

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Funding

This research was supported by the National Cancer Institute at the National Institutes of Health Grants R01CA129769 and R35CA197289 to JM. This work was supported in part by the National Institute of Aging at the National Institutes of Health Grant R01 AG068193 to JM. As a member of the Cancer and Aging Research Group (CARG), JM’s work on this project was also supported in part by grant R33AG059206 (MPI: W Dale, S Mohile, H Klepin) from the National Institute of Aging at the National Institutes of Health. This study was also supported in part by the National Cancer Institute at the National Institutes of Health Grant P30CA51008 to Georgetown Lombardi Comprehensive Cancer Center for support of the Biostatistics and Bioinformatics Resource and the Non-Therapeutic Shared Resource. The work of AJS was supported in part by the National Institute of Aging at the National Institutes of Health Grants P30AG10133, R01AG19771 and R01LM01136. TAA was supported in part by National Cancer Institute at the National Institutes of Health Grants R01CA172119, U54 CA137788, and P30CA008748. JR was supported in part by National Cancer Institute at the National Institutes of Health grant R01CA172119. BCM was supported in part by National Cancer Institute at the National Institutes of Health Grant R01CA244673. KVD was supported in part by the National Cancer Institute at the National Institutes of Health Grant K08CA241337. The work of JEC was supported in part by the American Cancer Society Research Scholars Grant 128660-RSG-15-187-01-PCSM and the National Cancer Institute at the National Institutes of Health Grant R01CA237535. HJC was supported in part by the National Institute of Aging at the National Institutes of Health Grant P30AG028716 for the Duke Pepper Center. SKP was supported in part by the American Cancer Society Research Scholars Grant RSG-17-023-01-CPPB. The CogAge study was supported by a National Grant (Inca Programme Hospitalier de Recherche Clinique, Grant APN 2008 n°06-08) and Sanofi.

Author information

Author notes

  1. Brent J. Small and Marie Lange contributed equally as first authors.

  2. Jeanne Mandelblatt and Florence Joly contributed equally as senior authors.

Authors and Affiliations

  1. School of Aging Studies, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL, 33620, USA

    Brent J. Small

  2. Medical Oncology Department, Centre François Baclesse, and Normandie University, UNICAEN, INSERM, ANTICIPE, and Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, Caen, France

    Marie Lange & Florence Joly

  3. Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

    Wanting Zhai, Jaeil Ahn & Xingtao Zhou

  4. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Tim A. Ahles & James C. Root

  5. UCLA Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Jonsson Comprehensive Cancer Center and Cousins Center for Psychoneuroimmunology, Jane and Terry Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA

    Judith E. Carroll

  6. Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA

    Harvey J. Cohen

  7. John Theurer Cancer Center, Hackensack, NJ, USA

    Deena Graham

  8. Department of Oncology Sciences, Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL, USA

    Martine Extermann

  9. Department of Clinical Research, Center François Baclesse, and Normandie Université, Caen, France

    Natacha Heutte

  10. Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA

    Heather S. L. Jim

  11. Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine and the Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA

    Brenna C. McDonald & Andrew J. Saykin

  12. Departments of Population Sciences and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA

    Sunita K. Patel

  13. Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine, Jonsson Comprehensive Cancer Center, UCLA, Semel Institute, Los Angeles, CA, USA

    Kathleen Van Dyk

  14. Department of Oncology, Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

    Jeanne Mandelblatt

Authors
  1. Brent J. Small
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  2. Marie Lange
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For the Thinking Living with Cancer C. O. G.-Age Studies

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Correspondence to Brent J. Small.

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Brent J. Small, Marie Lange, Florence Joly, and Jeanne Mandelblatt were the writing committee for this manuscript.

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Small, B.J., Lange, M., Zhai, W. et al. Impact of taxane-based chemotherapy among older women with breast cancer on cognition and quality of life: a longitudinal pooled analysis. Breast Cancer Res Treat 191, 459–469 (2022). https://doi.org/10.1007/s10549-021-06455-6

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  • DOI: https://doi.org/10.1007/s10549-021-06455-6

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