Abstract
Purpose
The aim of this study is to elucidate the role of taxanes on cognition when they are administered as a part of the treatment with a fluorouracil, epirubicin and cyclophosphamide (FEC) regimen for breast cancer (BC).
Methods
Two groups of women (n = 51) with a novel diagnostic of BC that were treated with a combination of FEC alone (6 cycles of FEC) or with taxanes (4 cycles of FEC plus 8 cycles of taxanes) were compared at three moments: before chemotherapy, after its completion (short-term evaluation) and at a mean of 74.5 weeks from baseline as a long-term evaluation.
Results
Both groups showed worsening in tests of attention and executive functions on the short-term assessment, with the group treated with taxanes showing more number of affected cognitive measures at this time point, including verbal learning and speed measures. At the long-term evaluation, cognitive dysfunction was still found in attention and executive functions in both groups.
Conclusion
Our results suggest that chemotherapy for BC with a FEC regimen can have a negative effect on cognition. Acute deficits seem to be larger when taxanes are added, but treatment seems to affect cognition also at long term.
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References
Ahles TA, Saykin AJ, Furstenberg CT, Cole B, Mott LA, Skalla K et al (2002) Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. J Clin Oncol 20(2):485–493
Hurria A, Somlo G, Ahles T (2007) Renaming ‘chemobrain’. Cancer Invest 25(6):373–377
Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA (2004) The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer 100(11):2292–2299
Ganz P (1998) Cognitive dysfunction following adjuvant treatment of breast cancer: a new dose-limiting toxic effect? J Natl Cancer Inst 90(3):182–183
Oxman TE, Silverfarb PM (1980) Serial cognitive testing in cancer patients receiving chemotherapy. Am J Psychiatry 137(10):1263–1265
Wefel JS, Vardy J, Ahles T, Schagen SB (2011) International cognition and cancer task force recommendations to harmonise studies of cognitive function in patients with cancer. Lancet Oncol 12(7):703–708
Hodgson KD, Hutchinson AD, Wilson CJ, Nettelbeck T (2013) A meta-analysis of the effects of chemotherapy on cognition in patients with cancer. Cancer Treat Rev 39(3):297–304
Phillips K-A, Bernhard J (2003) Adjuvant breast cancer treatment and cognitive function: current knowledge and research directions. J Natl Cancer Inst 95(3):190–197
Jansen CE, Cooper BA, Dodd MJ, Miaskowski CA (2011) A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. Support Care Cancer 19(10):1647–1656
Van Der Veldt AAM, Hendrikse NH, Smit EF, Mooijer MPJ, Rijnders AY, Gerritsen WR et al (2010) Biodistribution and radiation dosimetry of 11C-labelled docetaxel in cancer patients. Eur J Nucl Med Mol Imaging 37(10):1950–1958
Janelsins MC, Kohli S, Mohile SG, Usuki K, Ahles TA, Morrow GR (2011) An update on cancer- and chemotherapy-related cognitive dysfunction: current status. Semin Oncol 38(3):431–438
Fardell JE, Vardy J, Johnston IN (2013) The short and long term effects of docetaxel chemotherapy on rodent object recognition and spatial reference memory. Life Sci 93(17):596–604
Wefel JS, Saleeba AK, Buzdar AU, Meyers CA (2010) Acute and late onset cognitive dysfunction associated with chemotherapy in women with breast cancer. Cancer 116(14):3348–3356
Jim H (2012) Long-term effects of chemo on the cognitive function of cancer patients. Oncology 26:1012–1014
Pena-Casanova J, Blesa R, Aguilar M, Gramunt-Fombuena N, Gomez-Anson B, Oliva R et al (2009) Spanish multicenter normative studies (NEURONORMA Project): methods and sample characteristics. Arch Clin Neuropsychol 24(4):307–319
Vearncombe KJ, Pachana NA (2009) Is cognitive functioning detrimentally affected after early, induced menopause? Menopause 16(1):188–198
Bartels C, Wegrzyn M, Wiedl A, Ackermann V, Ehrenreich H (2010) Practice effects in healthy adults: a longitudinal study on frequent repetitive cognitive testing. BMC Neurosci 11(1):118
Hermelink K, Untch M, Lux MP, Kreienberg R, Beck T, Bauerfeind I et al (2007) Cognitive function during neoadjuvant chemotherapy for breast cancer: results of a prospective, multicenter, longitudinal study. Cancer 109(9):1905–1913
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4(6):561–571
Spielberger CD, Gorsuch RC, Lushene RE, Vagg PR, Jacobs GA (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto
Heaton RK, Grant I, Mathews CG (1991) Comprehensive norms for an expanded halstead-reitan battery: demographic corrections, research findings and clinical applications. Psychological Assessments Resources, Inc., Florida
Shilling V, Jenkins V, Morris R, Deutsch G, Bloomfield D (2005) The effects of adjuvant chemotherapy on cognition in women with breast cancer—preliminary results of an observational longitudinal study. Breast 14(2):142–150
Schagen SB, Van Dam FSAM (2006) Does cognitive impairment after chemotherapy for breast cancer improve over time or does practice make perfect? [1]. J Clin Oncol 24(32):5170–5171
Myers JS (2013) Cancer- and chemotherapy-related cognitive changes: the patient experience. Semin Oncol Nurs 29(4):300–307
Shilling V, Jenkins V, Fallowfield L, Howell T (2003) The effects of hormone therapy on cognition in breast cancer. J Steroid Biochem Mol Biol 86:405–412
Ono M, Ogilvie JM, Wilson JS, Green HJ, Chambers SK, Ownsworth T et al (2015) A meta-analysis of cognitive impairment and decline associated with adjuvant chemotherapy in women with breast cancer. Front Oncol 5:19
Mandilaras V, Wan-Chow-Wah D, Monette J, Gaba F, Monette M, Alfonso L (2013) The impact of cancer therapy on cognition in the elderly. Front Pharmacol 4:48
Bower JE (2008) Behavioral symptoms in patients with breast cancer and survivors. J Clin Oncol 26(5):768–777
Schagen SB, Muller MJ, Boogerd W, van Dam FSAM (2002) Cognitive disfunction and chemotherapy: neuropsychological findings in perspective. Clin Breast Cancer 3(3):100–108
Koppelmans V, Breteler MMB, Boogerd W, Seynaeve C, Gundy C, Schagen SB (2012) Neuropsychological performance in survivors of breast cancer more than 20 years after adjuvant chemotherapy. J Clin Oncol 30(10):1080–1086
Van Dam FSAM, Schagen SB, Muller MJ, Boogerd W, Wall EVD, Droogleever Fortuyn ME et al (1998) Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst 90(3):210–218
Chan RJ, Mccarthy AL, Devenish J, Sullivan KA, Chan A (2015) Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer. Eur J Cancer 51(4):437–450
Fardell JE, Vardy J, Johnston IN, Winocur G (2011) Chemotherapy and cognitive impairment: treatment options. Clin Pharmacol Ther 90(3):366–376
Acknowledgements
The authors would like to thank the women who participated in the study, and Carme Civit, Carme Aracil, Natalia Cuenca, Nuria de la Osa Chaparro, Carme Pérez-Ventana, Antonio Sánchez-Hidalgo, Resident Intern Psychologists (PIR) from Consorci Sanitari de Terrassa for their contribution.
Funding
The research support was provided by grants from the first prize of the Joan Costa I Roma Foundation (FJCR), Consorci Sanitari de Terrassa, a non-profit organization for research and innovation. None of the authors have financial relationship with the organization that sponsored the research.
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This study complies with the current laws of the country where it was performed.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Cerulla, N., Arcusa, À., Navarro, JB. et al. Role of taxanes in chemotherapy-related cognitive impairment: A prospective longitudinal study. Breast Cancer Res Treat 164, 179–187 (2017). https://doi.org/10.1007/s10549-017-4240-6
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DOI: https://doi.org/10.1007/s10549-017-4240-6