Cancer treatment-related cognitive impairment

There is a growing number of cancer survivors given improvement in early cancer diagnosis, therapeutics, and supportive care strategies. Cognitive impairment is among the most common and clinically significant symptoms managed by cancer survivors, which negatively impacts quality of life, functional and occupational status for patients and their care partners. Cancer-related cognitive impairment is often multifactorial-impacted by patient and cancer-specific factors. For systemic (non-CNS) malignancies, cognitive impairment has been identified in up to 75%, depending on cohort, which persists in up to 35% of patients in the years following initial treatment. The most common areas of impairment include memory and processing speed, and executive function. These adverse effects of cancer treatment have been reported after chemotherapy, hormone therapy, targeted therapy, and immunotherapy. This review will summarize existing knowledge regarding the nature and pattern of cognitive changes, mechanisms and risk factors underlying these changes, and biomarkers to support identification of this adverse consequence of cancer therapies.