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Impact of adjuvant anthracycline-based and taxane-based chemotherapy on plasma VEGF levels and cognitive function in early-stage breast cancer patients

Date

09 Oct 2016

Session

Poster display

Presenters

Raymond Ng

Citation

Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390

Authors

R. Ng1, X.Y. Phey2, T. Ng2, H.L. Yeo2, M. Shwe2, Y.X. Gan3, H.K. Ho2, A. Chan2

Author affiliations

  • 1 Medical Oncology, National Cancer Center, 169610 - Singapore/SG
  • 2 Pharmacy, National University of Singapore, Singapore/SG
  • 3 Pharmacy, National Cancer Center, Singapore/SG
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Background

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.

Methods

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®).

Results

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 

Conclusions

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

Funding

National Medical Research Council Singapore

Disclosure

All authors have declared no conflicts of interest.

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