Cancer-related cognitive impairment: a review of National Institutes of Health‑Funded grants (2017-2024)

Cancer-related cognitive impairment (CRCI) adversely affects cancer survivors' academic, occupational, and psychosocial functioning. Analyzing the National Institutes of Health (NIH) portfolio of funded research provides insight into current efforts, trends, and gaps in CRCI research.

We queried the internal NIH iSearch database to identify awards focused on CRCI. A total of 185 grants met inclusion criteria. Data were extracted from grant specific aims and methods. Awards were characterized by research stage (preclinical, clinical), cancer types, and treatments. Preclinical studies were coded for model type and cognitive assessments. Clinical studies were coded for trial design, inclusion criteria, cognitive outcomes, and biomarkers.

Of 185 grants, 67% involved clinical, 30% preclinical, and 3% both human and animal studies. Commonly studied cancer types were breast (31%), central nervous system (25%), and hematological (22%). Chemotherapy (34%) and radiotherapy (23%) were the most examined therapies, while biologic (8%) and hormonal (6%) therapies were less frequently studied. Among 130 clinical studies, 64% had observational and 38% had interventional components. The 48 interventional studies focused on behavioral/complementary (73%), pharmacologic (25%), and/or device (10%) interventions. Most clinical studies assessed cognition with objective (88%) and patient-reported outcomes (76%) measures.

Significant gaps persist in CRCI research related to high-incidence cancers such as prostate, lung, and colorectal, as well as in studies of emerging treatments like immunotherapy and hormonal therapy.

Findings highlight unmet needs and opportunities to advance mechanistic and interventional research that supports cognitive health and quality of life for all cancer survivors.