Decline in Cognitive Function in Older Adults With Early-Stage Breast Cancer After Adjuvant Treatment

Lange, Marie; Heutte, Natacha; Rigal, Olivier; Noal, Sabine; Kurtz, Jean‐Emmanuel; Lévy, Christelle; Allouache, Djelila; Rieux, Chantal; Lefel, Johan; Clarisse, Bénédicte; Veyret, Corinne; Barthélémy, Philippe; Longato, Nadine; Castel, Hélène; Eustache, Francis; Giffard, Bénédicte; Joly, Florence

doi:10.1634/theoncologist.2016-0014

Cited by 97 publications

(163 citation statements)

References 59 publications

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“…Minisini et al prospectively measured cognitive function in older patients with breast cancer who received no adjuvant treatment or were treated with chemotherapy with or without endocrine therapy and found that more patients in the chemotherapy group showed worsening memory skills, and more patients in the endocrine therapy and chemotherapy group experienced reduction in attention scores . Other studies have raised concerns about the short and long‐term impact of chemotherapy in older adults with breast cancer …”

Section: Aging Cognition and Cancermentioning

confidence: 99%

New Challenges in Psycho‐Oncology Research IV: Cognition and cancer: Conceptual and methodological issues and future directions

Ahles

Hurria

2018

Psycho-Oncology

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Section: Aging Cognition and Cancermentioning

confidence: 99%

New Challenges in Psycho‐Oncology Research IV: Cognition and cancer: Conceptual and methodological issues and future directions

Ahles

Hurria

2018

Psycho-Oncology

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“…Based on previous published results-which overall showed there was no significant difference between patient groups receiving or not receiving chemotherapy in objective cognitive decline in any cognitive domain or in at least one domain [5]-cognitive changes before to after treatment are presented independently of received treatment (chemotherapy and/or radiotherapy) and were elaborated from a decline in at least one domain.…”

Section: Discussionmentioning

confidence: 99%

“…A summary of sample characteristics and main previous results [5] is presented here to place the methods and results of the present study in context. Newly diagnosed women with EBC (n 5 119) aged more than 65 years and a sample of healthy controls (n 5 62) were included.…”

Section: Sample Characteristics: Data Previously Publishedmentioning

confidence: 99%

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Cognitive Changes After Adjuvant Treatment in Older Adults with Early-Stage Breast Cancer

et al. 2018

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This study described for the first time objective cognitive changes before to after treatment of older adults with EBC immediately after the end of adjuvant treatment. A longer-term remote follow-up of adjuvant treatment is needed to better understand the cognitive trajectories of older patients with EBC. IMPLICATIONS FOR PRACTICE: After the end of adjuvant treatment, 31% of older adults with early-stage breast cancer without initial objective cognitive impairment developed impairment, and 6% experienced accelerated cognitive decline. Initial cognitive functioning should be included in the balance of benefits and harms of systemic therapy for patients who are likely to be at highest risk for cognitive decline after cancer treatments. Regular cognitive follow-up of patients who had cognitive impairment before cancer treatment should monitor symptoms suggestive of neurodegenerative disease and avert the effect of cognitive disorders on patients' autonomy.

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“…In addition, there are few data on the long‐term effects with regards to quality of life and cognition. Lange et al demonstrated that older patients frequently present a cognitive decline after adjuvant chemotherapy, particularly docetaxel . In addition, adjuvant chemotherapy affects quality of life considerably in older patients .…”

Section: Incidence Of Main Adverse Eventsmentioning

confidence: 99%

Docetaxel/cyclophosphamide chemotherapy in older patients with breast cancer

et al. 2017

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Docetaxel/cyclophosphamide (TC) has become a standard chemotherapy for patients aged ≥65 years with high-risk early breast cancer (EBC) because of the absence of cardiotoxicity. 1 However in the phase III study, the median age was 51 years and 16% of patients were ≥65 years. 2,3 In this single-center retrospective analysis, we investigated the specific tolerance of TC in older women with EBC in routine daily practice at the UZ Brussel, Brussels, Belgium. From January 2010 till December 2012, 42 female patients aged ≥65 years with EBC were treated with (neo) adjuvant TC. The median age was 71 years old (range 65-82) and 30% of patients were ≥75 years. Seven patients (16.7%) had a HER2 amplification and were treated concomitantly with trastuzumab. Forty-one patients received pegfilgrastim most frequently as primary prophylaxis (pp) (81%). The observed adverse events (AEs) are listed in Table 1. All patients reported at least one AE and 15 patients (35.7%) experienced a grade 3/4 AE. The most common haematological toxicity was anemia (83.3%), mainly grade 1/2. Grade 3/4 neutropenia was observed in nine patients (21.5%), of whom four had received pp pegfilgrastim. Two patients presented with febrile neutropenia.The most common nonhaematological toxicities were fatigue (69%), diarrhea (54.8%), constipation (38.1%) and edema (38.1%).Thirteen patients (31%) developed infections, all but one in the absence of neutropenia. Ten patients (27%) were hospitalized because of serious nonhaematological AEs: five patients with infections, three with gastrointestinal AEs, one with pulmonary embolism and one interstitial pneumonitis (IP) in a patient treated concomitantly with trastuzumab, which resulted in a treatment-related death. Table 2 compares the TC related AEs reported in the present trial and in three previously published reports. 2,4,5In all reports, haematological toxicities were frequently observed with the TC regimen, most prominently neutropenia. In the present analysis, neutropenia and febrile neutropenia were less frequent

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Decline in Cognitive Function in Older Adults With Early-Stage Breast Cancer After Adjuvant Treatment

Cited by 97 publications

References 59 publications

New Challenges in Psycho‐Oncology Research IV: Cognition and cancer: Conceptual and methodological issues and future directions

New Challenges in Psycho‐Oncology Research IV: Cognition and cancer: Conceptual and methodological issues and future directions

Cognitive Changes After Adjuvant Treatment in Older Adults with Early-Stage Breast Cancer

Docetaxel/cyclophosphamide chemotherapy in older patients with breast cancer

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