Assessment of Cancer-Related Cognitive Impairments Across Anti-Cancer Therapies in a Predominantly Breast Cancer...

Cancer survivors frequently experience cancer-related cognitive impairment (CRCI), but the contributions of different anti-cancer therapies remain unclear. Patients with breast or gynaecological cancer were recruited before any anti-cancer treatment. Cognitive function was assessed by objective and subjective measures pre-treatment (T0), post-treatment (T1), and 1 year after T1 (T2). Objective measures include Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test (TMT), Controlled Oral Word Association Test (COWA), and Mnemonic Similarity Task (MST). Subjective measures include Functional Assessment of Cancer Therapy-Cognitive scale (FACT-Cog) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Linear mixed models were performed. Patients (n = 234) were of age 55.4 ± 11.6 years. At T1, chemotherapy was associated with worse visual searching and motor speed (TMT-A: β = 0.36, 95% CI: 0.03-0.69), perceived global function (FACT-Cog Global Function: β = -0.39, 95% CI: -0.67 to -0.11), and cognitive function (EORTC QLQ-C30: β = -0.50, 95% CI: -0.82 to -0.18) compared to endocrine therapy. At T2, endocrine therapy was associated with poorer verbal learning and memory performance (HVLT-R total recall: β = -0.40, 95% CI: -6 to -0.03) and higher perceived cognitive impairments (FACT-Cog PCI: β = 0.34, 95% CI: 0.05-0.63). In conclusion, CRCI may occur during certain types of chemotherapy but appears to ameliorate over time. Ongoing endocrine therapy may have longer-lasting impact on cognitive function. Appropriate counselling for informed decision making and good supportive care is needed.