Vascular endothelial growth factor (VEGF) has been shown to induce neurogenesis in the brain and yield neuroprotective effects. It is hypothesized that adjuvant chemotherapy containing doxorubicin or taxane, reduces circulating VEGF levels and, in turn, leads to cognitive decline in cancer patients who receive chemotherapy. This multicenter, longitudinal study was designed to evaluate the impact of chemotherapy on VEGF levels and the association between VEGF levels and cognitive function.
One hundred and forty-six early-stage breast cancer patients were recruited and assessed at three time points: before chemotherapy (T1), during chemotherapy (T2) and at the end of chemotherapy (T3). At each time point, we quantified plasma VEGF levels using a multiplex immunoassay (Luminex®). Self-perceived cognitive functioning was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function Version, and objective cognitive functioning was assessed using Headminder™. Plasma VEGF levels were quantified using a multiplex immunoassay (Luminex®).
The average age of this cohort was 50.5 ± 9.2 years, with the majority being Chinese (82.9%), and diagnosed with Stage II breast cancer (56.2%). Forty-one (28.3%) patients reported self-perceived cognitive impairment at the end of chemotherapy, with impairment in the attention (7.2%) and memory (11.0%) domains detected using Headminder™. Among the patients who received an anthracycline-based chemotherapy regimen, the median plasma VEGF levels were significantly higher at T2 (T2: 37.0 pg/ml vs T1: 21.2 pg/ml; p
Breast cancer patients experience dysregulation in plasma VEGF levels during chemotherapy, and the regimen types may have a differential impact on circulating VEGF levels. However, changes in plasma VEGF levels during chemotherapy were not associated with cognitive impairment.
Clinical trial identification
Legal entity responsible for the study
Singhealth CIRB; National Cancer Centre Singapore
National Medical Research Council Singapore
All authors have declared no conflicts of interest.