Assessment of Cancer‐Related Cognitive Impairments Across Anti‐Cancer Therapies in a Predominantly Breast Cancer Cohort

ABSTRACT

Cancer survivors frequently experience cancer‐related cognitive impairment (CRCI), but the contributions of different anti‐cancer therapies remain unclear. Patients with breast or gynaecological cancer were recruited before any anti‐cancer treatment. Cognitive function was assessed by objective and subjective measures pre‐treatment (T0), post‐treatment (T1), and 1 year after T1 (T2). Objective measures include Hopkins Verbal Learning Test‐Revised (HVLT‐R), Trail Making Test (TMT), Controlled Oral Word Association Test (COWA), and Mnemonic Similarity Task (MST). Subjective measures include Functional Assessment of Cancer Therapy—Cognitive scale (FACT‐Cog) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ‐C30). Linear mixed models were performed. Patients ( n  = 234) were of age 55.4 ± 11.6 years. At T1, chemotherapy was associated with worse visual searching and motor speed (TMT‐A: β  = 0.36, 95% CI: 0.03–0.69), perceived global function (FACT‐Cog Global Function: β  = −0.39, 95% CI: −0.67 to −0.11), and cognitive function (EORTC QLQ‐C30: β  = −0.50, 95% CI: −0.82 to −0.18) compared to endocrine therapy. At T2, endocrine therapy was associated with poorer verbal learning and memory performance (HVLT‐R total recall: β  = −0.40, 95% CI: −6 to −0.03) and higher perceived cognitive impairments (FACT‐Cog PCI: β  = 0.34, 95% CI: 0.05–0.63). In conclusion, CRCI may occur during certain types of chemotherapy but appears to ameliorate over time. Ongoing endocrine therapy may have longer‐lasting impact on cognitive function. Appropriate counselling for informed decision making and good supportive care is needed.