The Managing Cancer and Living Meaningfully (CALM) Intervention Alleviates Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer by Modulating Pan-Immune-Inflammation Values

Abstract

Background: The number of patients with breast cancer is increasing worldwide, resulting in a growing number of patients with chemotherapy-related cognitive impairment (CRCI), which seriously affects their quality of life. CRCI is associated with inflammatory factors and systemic inflammatory markers such as pan-immune-inflammation value (PIV) and monocyte-to-lymphocyte ratio (MLR), which can reflect the level of inflammation in the body. While the Managing Cancer and Living Meaningfully (CALM) intervention has been demonstrated to alleviate CRCI in patients with breast cancer, the specific mechanism remains unclear. Objective: This study evaluated the impact of the CALM intervention on systemic inflammation. Methods: Ninety patients with breast cancer with CRCI were enrolled and randomized into care as usual (CAU) and CALM intervention groups. All patients were assessed using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog), Mini-Mental State Exam (MMSE), and Functional Assessment of Cancer Therapy-Breast (FACT-B) before and after the CAU/CALM intervention. The blood levels of inflammatory markers were also analyzed before and after the intervention. Results: Compared to the CAU group, the CALM group showed significantly improved cognitive function and significantly decreased PIV ( P < .05). PIV was significantly negatively correlated with FACT-Cog ( P < .05). The levels of other inflammatory markers, including MLR, neutrophil-to-lymphocyte ratio (NLR), granulocyte-to-lymphocyte ratio (GLR), and systemic immune-inflammation index (SII), were also reduced in the CALM group. Conclusion: PIV is an important marker of inflammation. The CALM intervention may improve the cognitive function of patients by regulating the systemic inflammation marker PIV through the neuroimmune axis.

Diagnosis of chemotherapy-related cognitive impairment

“…Z kolei Yao i wsp. wskazują na średni wynik 22,4 pkt (SD 2,5) wśród pacjentek z chemobrain po leczeniu raka piersi [15]. Invitto i wsp.…”

“…Yao i wsp. (2022) wskazują na wykorzystanie wartości Pan-immune-inflammation (Pan-immune-inflammation value -PIV) jako wiarygodnego markera wystąpienia zaburzeń poznawczych po chemioterapii [15]. Jest on obliczany według wzoru (NEU × PLT × MONO)/LYM, gdzie NEU to liczba neutrofilów (10 3 /ml), PLT -liczba trombocytów (10 3 /ml), MONO -liczba monocytów (10 3 /ml), LYM -liczba limfocytów (10 3 /ml)).…”

Chemotherapy‐induced cognitive impairment in breast cancer survivors: A systematic review of studies from 2000 to 2021

“…Breast cancer is a major health concern for women, as it is the most prevalent type of cancer and the second leading cause of death among them 1,2 . In Iran, the age‐standardized incidence rate of breast cancer escalated from 18.8 per 100 000 in 1990 to 34.0 per 100 000 in 2019 among females and from 0.2 to 0.3 per 100 000 among males 3 .…”

“…Therefore, this systematic review aims to provide a comprehensive and up‐to‐date synthesis of the evidence on the specific effects of chemotherapy on the cognitive functions of breast cancer survivors. It will address the following research questions 1 : which domains or aspects of cognitive functions are most affected by chemotherapy? 2 how long does CRCI last after completing chemotherapy? and 3 what is the long‐term effect of using chemotherapy on cognitive functions?…”

“…Breast cancer is a major health concern for women, as it is the most prevalent type of cancer and the second leading cause of death among them. 1,2 In Iran, the age-standardized incidence rate of breast cancer escalated from 18.8 per 100 000 in 1990 to 34.0 per 100 000 in 2019 among females and from 0.2 to 0.3 per 100 000 among males. 3 Advancements in oncology, surgery, and treatments such as radiotherapy, chemotherapy, and hormone therapy have significantly improved the survival rate of breast cancer patients, with over 90% surviving for 5 years.…”