Anthracycline Impact on Breast Cancer Survivor Memory Challenged

Neuropsychological findings refute the suggestion that anthracycline breast cancer treatment may be linked to cognitive decline

medwireNews: Researchers have failed to find evidence to support a greater risk of lasting cognitive decline in breast cancer patients given an anthracycline-based chemotherapy than those given other regimens or no chemotherapy.

The team examined neuropsychological test results from the Mind Body Study for 190 breast cancer survivors assessed within 3 months of their primary treatment, of whom 173 were reassessed at 6 months and 1 year, and 102 after a mean of 4.8 years.

These included 92 patients who did not receive chemotherapy, 74 who received chemotherapy without an anthracycline and 24 patients who were given anthracycline-based treatment.

After adjusting for age, IQ and receipt of endocrine therapy, there were no significant differences among the treatment groups with regard to verbal learning, verbal memory, processing speed or executive function at any time point. Nor did the groups differ with regard to performances on tests of executive function and verbal fluency or visual memory.

Indeed, cognitive function during and after recovery was comparable among the treatment groups for up to 7 years after treatment, say Patricia Ganz, from UCLA Jonsson Comprehensive Cancer Center in Los Angeles, USA, and co-workers.

“We did not find an association between anthracycline exposure and neuropsychological performance on any measure examined”, they emphasize in JAMA Oncology.

The authors acknowledge that the current longitudinal study results contrast with those of an earlier cross-sectional study indicating lower memory scores an average of 2 years after treatment in anthracycline-exposed patients.

However, believing that their battery of neuropsychological tests had more challenging memory measures than the previous study, they comment that the “discrepancy is not due to differential sensitivity”.

The researchers therefore conclude that “in this study we could not find evidence to support the claim that anthracycline treatment confers greater risk of cognitive decline for breast cancer survivors.”

Reference

Van Dyk K, Petersen L, Ganz PA. Comparison of neurocognitive function after anthracycline-based chemotherapy vs nonanthracycline-based chemotherapy. JAMA Oncol 2016; Advance online publication 21 April. doi:10.1001/jamaoncol.2016.0350

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