[JAMA Oncol] reverse: Anthracycline not Affect Cognitive Function in Breast Cancer Survivors

JAMA Oncol Following a retrospective study published in February, suggesting that anthracycline-based chemotherapy in breast cancer survivors may cause cognitive impairment, recently published another study. This study is an early study of patients were followed up for 7 years and data analysis, the results surprising. The results showed that anthracyclines and does not cause cognitive deficits in patients receiving containing / anthracycline chemotherapy patients and patients not receiving chemotherapy does not contain, related to cognitive scores did not differ. NMT Medical reported.

According to recent data published in JAMA Oncol analysis of a prospective longitudinal study show psychosomatic, anthracycline-based chemotherapy (such as doxorubicin or epirubicin) patients, after nearly seven years of follow-up treatment It does not appear the extra cognitive problems.

In fact long-term follow-up, patients receiving chemotherapy (with / without anthracyclines) with patients not receiving chemotherapy cognitive memory, processing speed, ability to execute scores did not differ.

“Before the study, we did not find any evidence to support claims received anthracycline therapy in breast cancer survivors there is a greater awareness to reduce the risk,” study corresponding author, University of California Los Angeles (UCLA) Jonsson Comprehensive Cancer Dr. Patricia A. Ganz Center said, “all the indicators we tested, were found to anthracyclines exposure and correlated neuropsychological behavior.”

It is widely suspected breast cancer treatment affects cognition – a side effect of chemotherapy is often called the brain. However, it is still unclear what kind of chemotherapy drugs is decisive, or there are other factors driving the side effects.

Ganz team findings and a recent retrospective cross-sectional study results contradict. The cross-sectional study show anthracycline chemotherapy for breast cancer survivors in the lower memory scores after treatment than those receiving no anthracyclines chemotherapy survivors at 2 years.

Information: JAMA Oncol: anthracycline drugs on cognitive function in breast cancer survivors

Ganz team, explains, two studies conflicting results not from differences in susceptibility testing. In fact, it performed to detect memory than the cross-sectional study in Psychosomatic research more difficult.

“We were not particularly surprised” The long-term results of psychosomatic research, the first author of the study, Kathleen Dr. Van Dyk UCLA Neuroscience and Human Behavior Semel Institute sermon, “can look forward to the coming year will be in the treatment of some progress. more importantly, we found that cognitive trajectory between several groups did not differ. ”

Before there was psychosomatic research shows first-line treatment and adjuvant treatment of anthracycline exposure and cognitive no immediate relevance. And this study, the researchers studied the physical and psychological 190 breast cancer survivors were seven years of follow-up, assessment of cognitive function in patients after treatment four times a node: three months, six months, 1 year, up to 6.9 years.

Analysis showed that after adjustment for age, IQ and history of endocrine therapy, group or between 7 neuropsychological detection group × time interactions were not under any significant difference (P> 0.05). Further, in the executive function / language fluency (FAS) or visual memory aspect, the interaction between the two groups and no significant differences.

“With the progress and completion of this study is similar to cancer treatment of chemotherapy-related cognitive defects or evidence related brain will be more and more”, Alabama State University, and Dr. Elizabeth Kvale maintenance therapy clinic medical director of Survivors He said, “many patients have a clear showing symptoms of the brain chemotherapy, and this study shows that exposure to chemotherapy, especially anthracycline-based chemotherapy exposure, and does not cause cognitive impairment. we look forward to be able to explain this neuropsychological testing data symptoms. ”

And other studies suggest that exposure to chemotherapy cause nerve damage detection of different psychological, “This is a well-designed studies of data analysis,” Dr. Kvale Road.

However, in the understanding of cognitive impairment and risk factors in patients with respect, this study is still in the early research. After still waiting for cancer-related cognitive impairment have a further understanding of the origin, will it be possible to develop prevention strategies, Dr. Kvale explained. She recommended clinical doctors and patients to discuss the possibility of cognitive deficits. “There is no doubt, so that cancer patients understand the treatment of this syndrome is very common and survival is very important. Oncologists and primary care physicians can be severe cognitive impairment screening, and when a patient in need of give specific neuropsychological education and support. ”

“We have evidence to support the treatment of chemotherapy brain symptoms and rehabilitation benefits exist,” Dr. Kvale said, “Therefore, the health care providers to raise awareness in this regard is very important.”

We are currently needed is a lot of further study, Dr. Van Dyk said, “treatment factors, such as choice of chemotherapy drugs, is one of the objects emphasis on the need, but other factors, such as hormonal therapy, causes, complications, and pressure psychological problems, may all play a role. the key issue is to continue to explore in order to better understand these risks. ”

As for the status quo, “Our findings could help doctors change their ideas, dispel anthracyclines may cause concern of cognitive impairment,” Dr. Van Dyk concluded.