BCa: long-term endocrine therapy has no effect on cognition

  • Van Dyk K & al.
  • Cancer
  • 28 Nov 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Long-term endocrine therapy (ET) is associated with neither cognitive deficits nor impairment in women with hormone receptor (HR)-positive breast cancer (BCa).

Why this matters

  • Previous studies of shorter duration found worse cognition.
  • This was the longest prospective cohort.
  • Findings should be reassuring to women receiving ET.

Study design

  • Prospective Mind Body Study of women receiving ET (n=63) vs no ET (n=126) for HR+ BCa.
  • Neuropsychological test battery covering 6 domains (including learning, memory, and attention) performed at baseline, 6 months, and 12 months and at 3-6 years.
  • Impairment defined by test scores that were less than −1.5 or less than −2 z score, according to the International Cognition and Cancer Task Force guidelines.
  • Funding: NIH.

Key results

  • Mean follow-up, 4.3 years.
  • There was no main effect of ET (vs no ET) on learning (P=.12), memory (P=.28), attention (P=.96), visuospatial (P=.28), executive function (P=.97), or processing speed (P=.15), after adjusting for age, IQ, depression, race, and chemotherapy exposure.
  • No interaction of ET by time (baseline, 6-month, 12-month, and 3-6-year visits) for any of the domains listed here.
  • ET (vs no ET) was not associated with impairment at 6 months (P=.36), 12 months (P=.80), or 3-6 years (P=.53).

Limitations

  • Observational design.
  • Uncertain generalizability because of mostly white, highly educated participants.

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