Impact of new generation hormone-therapy on cognitive function in elderly patients treated for a metastatic prostate...

Area of Science:

• Oncology
• Geriatrics
• Neuroscience

Background:

• New generation hormone therapies (NGHT) targeting the androgen signaling pathway are used for metastatic castration-resistant prostate cancer (CRPCa) in elderly patients.
• The impact of NGHT on cognitive function in this population remains unevaluated, despite potential effects on patient autonomy and treatment adherence.
• Cognitive impairment can significantly affect the quality of life and self-management of elderly cancer patients.

Purpose of the Study:

• To prospectively assess the incidence of cognitive impairment in elderly men undergoing NGHT for metastatic CRPCa.
• To evaluate the impact of NGHT on cognitive performance, autonomy, quality of life, and treatment adherence.
• To compare the cognitive effects of different NGHT (abiraterone acetate and enzalutamide) and identify influencing factors like comorbidities.

Main Methods:

• The Cog-Pro study is a multicenter, longitudinal study involving CRPCa patients (≥70 years) on NGHT (n=134), control prostate cancer patients on first-generation androgen deprivation therapy (n=55), and healthy participants (n=33).
• Cognitive, geriatric, quality of life, and biological assessments were conducted at baseline, 3, 6, and 12 months post-treatment initiation.
• The primary endpoint was the proportion of patients experiencing cognitive decline within 3 months of NGHT initiation.

Main Results:

• The study aims to determine the primary endpoint: the proportion of elderly patients receiving NGHT who experience cognitive decline within 3 months.
• Secondary endpoints include changes in autonomy, quality of life, anxiety, depression, cognitive reserve, and treatment adherence.
• Analysis will also compare cognitive impacts between abiraterone acetate and enzalutamide, and assess the influence of comorbidities and biological factors.

Conclusions:

• Assessing cognitive impairment incidence, severity, and impact on quality of life, autonomy, and adherence in advanced prostate cancer patients is crucial.
• Findings will enhance cancer care for elderly patients and support the safe use of oral hormone therapies by highlighting adherence risks.
• Results will provide valuable information for patients, caregivers, and physicians to guide treatment decisions regarding NGHT and cognitive function.