News | Women's Health | April 21, 2016

No Cognitive Decline for Breast Cancer Patients with Chemotherapy Agent

Patients considering anthracycline-based chemotherapies need not fear greater risk for neuropsychological impairments following this treatment, researchers say

chemotherapy, anthracycline, cognitive decline, UCLA study, JAMA Oncology

April 21, 2016 — A new study by University of California Los Angeles (UCLA) researchers found a commonly used chemotherapy drug shows no association with cognitive decline following treatment in women with breast cancer. The report addresses recent concerns that the specific use of anthracycline-based therapies can lead to decreased neuropsychological functioning and cognitive difficulties, such as memory loss. 

The study will be published online April 21 by the journal JAMA Oncology

Anthracyclines (doxorubicin, epirubicin) are a class of chemotherapy drugs used to treat many types of breast cancers. But recent research linking anthracyclines to cognitive impairment after treatment has led to great uncertainty among physicians and patients as to their risk for the potential of cognitive decline after treatment. The need to fully understand risks associated with this specific type of chemotherapy remains urgent. 

Led by Patricia Ganz, M.D., and Kathleen Van Dyk, Ph.D., the UCLA researchers analyzed data from the previous Mind Body Study (MBS) that examined a large sample of women with breast cancer immediately after cancer treatment and followed them for an extended time. All of the patients had received neuropsychological evaluations conducted at up to four time points after treatment (from 3 months to 6.9 years). 

To assess the effects of the anthracycline treatment, the team categorized the patients into three groups: those receiving anthracycline chemotherapy, those receiving non-anthracycline chemotherapies and those receiving no chemotherapy at all. They then compared the neuropsychological test scores among the treatment groups and across all four time points, controlling for age, intelligence quotient and history of treatment with endocrine therapy. 

The scientists found that cognitive functioning after breast cancer treatment, in the areas of memory, processing speed and executive function, was comparable among all three groups of patients. 

Results further showed that there were no differences in cognitive functioning over time (during and after recovery) between the three patient groups up to seven years following treatment, Ganz said.

"These results are very exciting because we found no strong evidence linking anthracycline treatment to cognitive decline," said Ganz, director of cancer prevention and control research at the UCLA Jonsson Comprehensive Cancer Center. "If a physician is recommending anthracycline-based chemotherapy, we do not believe women should be excessively fearful that it is any more likely to cause cognitive difficulties than other types of chemotherapies."

The scientists will continue to focus on research efforts that reveal risk and mechanisms for cognitive dysfunction in breast cancer survivors and investigate promising interventions to treat those patients who experience cognitive decline. 

"Experiencing cognitive dysfunction after cancer and its treatment can be extremely disruptive to the lives of breast cancer survivors and it is critical to better understand what factors, including treatment, might put someone at greater risk for these types of problems," Van Dyk said. "These results bring us an important step further toward uncovering the influence of treatment on cognitive problems in these women."

The research was supported by the National Cancer Institute and the Breast Cancer Research Foundation.

For more information: www.oncology.jamanetwork.com

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