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Wu B, Yang X, Chen F, Song Z, Ding X, Wang X. Apolipoprotein E is a prognostic factor for pancreatic cancer and associates with immune infiltration. Cytokine 2024; 179:156628. [PMID: 38704962 DOI: 10.1016/j.cyto.2024.156628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/12/2024] [Accepted: 04/28/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND The expression level of apolipoprotein E (APOE) in pancreatic ductal adenocarcinoma (PDAC) and its effect on the prognosis of PDAC patients are not clear. The effect of APOE on the immune status of patients with PDAC has not been elucidated. METHODS We obtained pancreatic cancer data from the TCGA and GETx databases. Patients with PDAC who underwent pancreatic surgery at the Second Affiliated Hospital of Jiaxing University between 2012 and 2021 were included. Clinical pathological data were recorded, plasma APOE levels were measured, and tissue samples were collected. A tissue microarray was generated using the collected tissue samples. APOE and CD4 staining was performed to determine immunoreactive scores (IRSs). The expression of APOE in the plasma and tumour tissues of pancreatic cancer patients was analysed and compared. The correlations between plasma APOE levels, tissue APOE levels and clinicopathological characteristics were analysed. Survival prognosis was analysed using Kaplan-Meier survival analysis and Cox multivariate regression analysis. The correlations between APOE expression levels and immune biomarkers and immune cells were further analysed. Single-cell analysis of APOE distribution in various cells was performed on the TISCH website. RESULTS APOE was highly expressed in the tumour tissue of pancreatic cancer patients, and high plasma APOE levels were associated with poor prognosis. Females, patients with high-grade disease and patients with pancreatic head carcinoma had high plasma APOE levels. High APOE expression in tumour tissues was associated with good prognosis. Mononuclear macrophages in the pancreatic cancer microenvironment primarily expressed APOE. APOE levels positively correlated with immune biomarkers, such as CD8A, PDCD1, GZMA, CXCL10, and CXCL9, in the tumour microenvironment. APOE promoted CD4 + T cell or dendritic cell infiltration in the tumour microenvironment. CONCLUSIONS APOE may affect the occurrence and development of pancreatic cancer by regulating the infiltration of immune cells in the tumour microenvironment.
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Affiliation(s)
- Bin Wu
- Department of Surgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China
| | - Xiaodan Yang
- Department of Surgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China
| | - Fei Chen
- Department of Surgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China
| | - Zhengwei Song
- Department of Surgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China
| | - Xuhui Ding
- Department of Hospital Sense,The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China.
| | - Xiaoguang Wang
- Department of Surgery, the Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang 314000, P.R. China.
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2
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Wefel JS, Deshmukh S, Brown PD, Grosshans DR, Sulman EP, Cerhan JH, Mehta MP, Khuntia D, Shi W, Mishra MV, Suh JH, Laack NN, Chen Y, Curtis AA, Laba JM, Elsayed A, Thakrar A, Pugh SL, Bruner DW. Impact of Apolipoprotein E Genotype on Neurocognitive Function in Patients With Brain Metastases: An Analysis of NRG Oncology's RTOG 0614. Int J Radiat Oncol Biol Phys 2024; 119:846-857. [PMID: 38101486 PMCID: PMC11162903 DOI: 10.1016/j.ijrobp.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Whole-brain radiation therapy (WBRT) is a common treatment for brain metastases and is frequently associated with decline in neurocognitive functioning (NCF). The e4 allele of the apolipoprotein E (APOE) gene is associated with increased risk of Alzheimer disease and NCF decline associated with a variety of neurologic diseases and insults. APOE carrier status has not been evaluated as a risk factor for onset time or extent of NCF impairment in patients with brain metastases treated with WBRT. METHODS AND MATERIALS NRG/Radiation Therapy Oncology Group 0614 treated adult patients with brain metastases with 37.5 Gy of WBRT (+/- memantine), performed longitudinal NCF testing, and included an optional blood draw for APOE analysis. NCF test results were compared at baseline and over time with mixed-effects models. A cause-specific Cox model for time to NCF failure was performed to assess the effects of treatment arm and APOE carrier status. RESULTS APOE results were available for 45% of patients (n = 227/508). NCF did not differ by APOE e4 carrier status at baseline. Mixed-effects modeling showed that APOE e4 carriers had worse memory after WBRT compared with APOE e4 noncarriers (Hopkins Verbal Learning Test-Revised total recall [least square mean difference, 0.63; P = .0074], delayed recognition [least square mean difference, 0.75; P = .023]). However, APOE e4 carrier status was not associated with time to NCF failure (hazard ratio, 0.86; 95% CI, 0.60-1.23; P = .40). Memantine delayed the time to NCF failure, regardless of carrier status (hazard ratio, 0.72; 95% CI, 0.52-1.01; P = .054). CONCLUSIONS APOE e4 carriers with brain metastases exhibited greater decline in learning and memory, executive function, and the Clinical Trial Battery Composite score after treatment with WBRT (+/- memantine), without acceleration of onset of difference in time to NCF failure.
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Affiliation(s)
- Jeffrey S Wefel
- University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Snehal Deshmukh
- NRG Oncology Statistics and Data Management Center/American College of Radiology, Philadelphia, Pennsylvania
| | | | | | - Erik P Sulman
- Laura and Isaac Perlmutter Cancer Center, New York University Langone, New York, New York
| | | | - Minesh P Mehta
- Baptist Hospital of Miami and Florida International University, Miami, Florida
| | | | - Wenyin Shi
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Mark V Mishra
- University of Maryland Medical Systems, Baltimore, Maryland
| | - John H Suh
- Cleveland Clinic Foundation, Cleveland, Ohio
| | | | | | - Amarinthia Amy Curtis
- Spartanburg Medical Center, Accruals for Upstate Carolina NCORP-Gibbs Regional Cancer Center, Spartanburg, South Carolina
| | - Joanna M Laba
- London Regional Cancer Program, Accruals for University of Western Ontario, London, Ontario, Canada
| | - Ahmed Elsayed
- Toledo Community Hospital Oncology Program CCOP, Toledo, Ohio
| | - Anu Thakrar
- John H. Stroger Jr Hospital of Cook County MBCCOP, Chicago, Illinois
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center/American College of Radiology, Philadelphia, Pennsylvania
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3
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Liu Y, Li RL, Chen L, Zhao FY, Su YL, Jin S, Liu JE. Construction and validation of a risk-prediction model for chemotherapy-related cognitive impairment in patients with breast cancer. J Cancer Surviv 2024:10.1007/s11764-024-01566-7. [PMID: 38512563 DOI: 10.1007/s11764-024-01566-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE To identify risk factors of chemotherapy-related cognitive impairment (CRCI) and construct and validate a visual prediction model of such for patients with breast cancer. METHODS A multicenter, descriptive, and cross-sectional design was adopted. Data were collected from ten public tertiary hospitals in China. Cognitive function was assessed by using Functional Assessment of Cancer Therapy-cognitive function. Socio-demographic, clinical, psychological, and physical indicators were also assessed. The logistic prediction model was constructed by fivefold cross-validation. Then, a nomogram was utilized to visualize the prediction model, which was also evaluated via discrimination, calibration, and decision curve analysis. RESULTS A total of 71 breast cancer patients had CRCI with a prevalence of 9.58%. This visual prediction model was constructed based on education background, exercise frequency, chemotherapy times, and fatigue and demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.882. The calibration curve indicated good agreement between experimental and projected values, and the decision curve proved good clinical applicability. CONCLUSION Education background, exercise frequency, chemotherapy times, and fatigue were associated with high incidence of CRCI. The prediction model exhibits superior performance and has promise as a useful instrument for assessing the likelihood of CRCI in breast cancer patients. IMPLICATIONS FOR CANCER SURVIVORS Our findings could provide breast cancer survivors with risk screening based on CRCI predictors to implement prevention and early intervention, and help patients integrate into society and achieve comprehensive recovery.
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Affiliation(s)
- Yu Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ruo-Lin Li
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Lu Chen
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Fu-Yun Zhao
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Ya-Li Su
- Department of Breast Oncology, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring Road West, 100050, Beijing, China
| | - Shuai Jin
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You An Men, 100069, Beijing, China.
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4
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Demby T, Gross PS, Mandelblatt J, Huang JK, Rebeck GW. The chemotherapeutic agent doxorubicin induces brain senescence, with modulation by APOE genotype. Exp Neurol 2024; 371:114609. [PMID: 37944881 PMCID: PMC11302516 DOI: 10.1016/j.expneurol.2023.114609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/18/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
Many cancer patients experience serious cognitive problems related to their treatment, which can greatly affect their quality of life. The molecular mechanisms of this cancer chemotherapy-induced cognitive impairment (CICI) are unknown, thus slowing the development of preventative approaches. We hypothesized that cancer chemotherapies could induce cellular senescence in the brain, creating a pro-inflammatory environment and damaging normal brain communication. We tested this hypothesis using the common chemotherapeutic agent doxorubicin in two independent mouse models. In the first model, we used mice that express tdTomato under the pdkn2a (p16) promoter; p16 is a regulator of cellular senescence, and its upregulation is denoted by the presence of fluorescently tagged cells. Two weeks after exposure to three doses of 5 mg/kg doxorubicin, the number of tdTomato positive cells were increased nearly three-fold in both the cerebral cortex and the hippocampus. tdTomato staining co-localized with neurons, microglia, oligodendrocyte precursor cells, and endothelial cells, but not astrocytes. In the second model, we used APOE knock-in mice, since the APOE4 allele is a risk factor for CICI in humans and mouse models. We isolated RNA from the cerebral cortex of APOE3 and APOE4 mice from one to 21 days after a single dose of 10 mg/kg doxorubicin. Using NanoString analysis of over 700 genes related to neuroinflammation and RT-qPCR analysis of cerebral cortex transcripts, we found two-fold induction of four senescence-related genes at three weeks in the APOE4 mice compared to the APOE3 control mice: p21(cdkn1a), p16, Gadd45a, and Egr1. We conclude that doxorubicin promotes cellular senescence pathways in the brain, supporting the hypothesis that drugs to eliminate senescent cells could be useful in preventing CICI.
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Affiliation(s)
- Tamar Demby
- National Institute of Diabetes and Digestive and Kidney Disease, Bethesda, MD, United States of America
| | - Phillip S Gross
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States of America
| | - Jeanne Mandelblatt
- Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center and Georgetown Lombardi Institute for Cancer and Aging Research, Georgetown University, Washington, DC, United States of America
| | - Jeffrey K Huang
- Department of Biology, Georgetown University, Washington, DC, United States of America
| | - G William Rebeck
- Department of Neuroscience, Georgetown University, Washington, DC, United States of America.
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5
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Thomas J, Keels J, Calzone KA, Badzek L, Dewell S, Patch C, Tonkin ET, Dwyer AA. Current State of Genomics in Nursing: A Scoping Review of Healthcare Provider Oriented (Clinical and Educational) Outcomes (2012-2022). Genes (Basel) 2023; 14:2013. [PMID: 38002957 PMCID: PMC10671121 DOI: 10.3390/genes14112013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023] Open
Abstract
In the 20 years since the initial sequencing of the human genome, genomics has become increasingly relevant to nursing. We sought to chart the current state of genomics in nursing by conducting a systematic scoping review of the literature in four databases (2012-2022). The included articles were categorized according to the Cochrane Collaboration outcome domains/sub-domains, and thematic analysis was employed to identify key topical areas to summarize the state of the science. Of 8532 retrieved articles, we identified 232 eligible articles. The articles primarily reported descriptive studies from the United States and other high-income countries (191/232, 82%). More than half (126/232, 54.3%) aligned with the "healthcare provider oriented outcomes" outcome domain. Three times as many articles related to the "knowledge and understanding" sub-domain compared to the "consultation process" subdomain (96 vs. 30). Five key areas of focus were identified, including "nursing practice" (50/126, 40%), "genetic counseling and screening" (29/126, 23%), "specialist nursing" (21/126, 17%), "nurse preparatory education" (17/126, 13%), and "pharmacogenomics" (9/126, 7%). Only 42/126 (33%) articles reported interventional studies. To further integrate genomics into nursing, study findings indicate there is a need to move beyond descriptive work on knowledge and understanding to focus on interventional studies and implementation of genomics into nursing practice.
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Affiliation(s)
- Joanne Thomas
- Genomics Policy Unit, Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK;
| | - Jordan Keels
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02476, USA;
| | - Kathleen A. Calzone
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- National Institutes of Health, National Cancer Institute, Center for Cancer Research, Genetics Branch, Bethesda, MD 20892, USA
| | - Laurie Badzek
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- Ross and Carol Nese College of Nursing, Penn State University, University Park, PA 16802, USA
| | - Sarah Dewell
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- School of Nursing, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - Christine Patch
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
- Engagement and Society, Wellcome Connecting Science, Hinxton CB10 1RQ, UK
| | - Emma T. Tonkin
- Genomics Policy Unit, Faculty of Life Sciences and Education, University of South Wales, Pontypridd CF37 1DL, UK;
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
| | - Andrew A. Dwyer
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02476, USA;
- Global Genomics Nursing Alliance (G2NA), Pontypridd CF37 1DL, UK; (K.A.C.); (L.B.); (S.D.); (C.P.)
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6
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Li W, Gan C, Yu S, Xu J, Tang L, Li Q, Zhu Z, Cheng H. GSK3β rs3107669 polymorphism implicates chemotherapy-associated retrospective memory deficits in breast cancer survivors. Am J Cancer Res 2023; 13:4961-4975. [PMID: 37970370 PMCID: PMC10636677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/08/2023] [Indexed: 11/17/2023] Open
Abstract
Glycogen synthase kinase-3β (GSK-3β) plays an important role in the development of neurodegenerative diseases. However, the underlying effect of GSK-3β polymorphism on chemobrain in cancer survivors is unclear. This study aimed to evaluate the correlation between GSK-3β polymorphism and chemotherapy-associated retrospective memory deficits in breast cancer survivors. The difference in GSK-3β gene expression between breast cancer patients and healthy controls was confirmed using bioinformatics technology. All participants (197 with breast cancer and 40 healthy controls) underwent prospective and retrospective memory tests, and five single-nucleotide polymorphism loci of GSK-3β (rs3107669, rs1154597, rs334543, rs334558 and rs3755557) were genotyped from peripheral blood. Breast cancer survivors had memory impairment after chemotherapy (P<0.0001). The expression difference of the GSK-3β gene was determined through bioinformation analysis, and a genotype frequency difference of GSK-3β rs3107669 was found between the breast cancer and healthy control groups. GSK-3β rs3107669 was a genetic risk in comparison to the healthy controls (OR=0.382; 95% CI=0.186-0.786; P=0.009). Breast cancer with the GSK-3β rs3107669 (C/A+A/A) genotype was a protective factor for chemobrain (Beta=-0.306; 95% CI=-5.556~-2.145; P<0.0001) from multiple linear regression. The C/A+A/A genotype carrier performed better on the retrospective memory test than the C/C genotype (z=-4.302, P<0.0001). Breast cancer patients with chemotherapy who also carried the GSK-3β rs3107669 (C/C) genotype more easily presented cognitive deficits. The GSK-3β rs3107669 polymorphism was a feasible genetic risk factor for chemotherapy-associated retrospective memory impairments in breast cancer survivors.
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Affiliation(s)
- Wen Li
- Department of Oncology, The Second Hospital of Anhui Medical UniversityHefei 230601, Anhui, P. R. China
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Chen Gan
- Department of Oncology, The Second Hospital of Anhui Medical UniversityHefei 230601, Anhui, P. R. China
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Sheng Yu
- Department of Oncology, The Second Hospital of Anhui Medical UniversityHefei 230601, Anhui, P. R. China
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Jian Xu
- Department of Oncology, The Second Hospital of Anhui Medical UniversityHefei 230601, Anhui, P. R. China
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Lingxue Tang
- Department of Oncology, The Second Hospital of Anhui Medical UniversityHefei 230601, Anhui, P. R. China
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Qiang Li
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Zhenwei Zhu
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
| | - Huaidong Cheng
- Department of Oncology, The Second Hospital of Anhui Medical UniversityHefei 230601, Anhui, P. R. China
- The Third School of Clinical Medicine, Southern Medical UniversityGuangzhou 510500, Guangdong, P. R. China
- Department of Oncology, Shenzhen Hospital of Southern Medical UniversityShenzhen 518000, Guangdong, P. R. China
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7
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McGinnis GJ, Holden S, Yu B, Ransom C, Guidarelli C, De B, Diao K, Boyce D, Thomas CR, Winters-Stone K, Raber J. Association of fall rate and functional status by APOE genotype in cancer survivors after exercise intervention. Oncotarget 2022; 13:1259-1270. [PMID: 36441715 DOI: 10.18632/oncotarget.28310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE/OBJECTIVES Cancer treatment survivors often report impaired functioning and increased falls. Not all survivors experience the same symptom burden, suggesting individual susceptibilities. APOE genotype is a potential genetic risk factor for cancer treatment related side effects. Lifestyle factors such as physical activity can mitigate the effect of APOE genotype on measures of clinical interest in individuals without a history of cancer. We tested the hypothesis that APOE genotype influences cancer treatment related side effects and symptoms as well as response to exercise intervention. MATERIALS AND METHODS Data from a subsample of a study of fall prevention exercise in post-treatment female cancer survivors aged 50-75 years old (https://clinicaltrials.gov NCT01635413) were used to conduct a secondary data analysis. ApoE genotype was determined by serum sampling. Physical functioning, frequency of falls, and symptom burden were assessed using survey instruments. RESULTS Data from 126 female cancer survivors a median of 49 months out from cancer diagnosis were analyzed. ApoE4 carriers trended toward a higher fall rate at baseline (p = 0.059), but after exercise intervention had a fall rate lower than E4 non-carriers both immediately after structured intervention (p = 0.013) and after 6 months of follow up (p = 0.002). E2 carriers did not show improved measures of depressive symptoms and self-report disability after exercise intervention. E3 homozygotes showed increased self report physical activity after the 6 month exercise intervention, but E4 and E2 carriers did not. CONCLUSIONS APOE genotype may modulate cancer treatment related side effects and symptoms and response to exercise intervention.
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Affiliation(s)
- Gwendolyn J McGinnis
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sarah Holden
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA
| | - Betty Yu
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA
| | - Charlton Ransom
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA
| | - Carolyn Guidarelli
- School of Nursing, Oregon Health and Science University, Portland, OR 97239, USA
| | - Brian De
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kevin Diao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - David Boyce
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Charles R Thomas
- Department of Radiation Medicine, Oregon Health and Science University, Portland, OR 97239, USA.,Department of Radiation Oncology, Dartmouth-Hitchcock's Dartmouth Cancer Center, Lebanon, NH 03756, USA
| | - Kerri Winters-Stone
- School of Nursing, Oregon Health and Science University, Portland, OR 97239, USA.,Knight Cancer Institute, Oregon Health and Science University, Portland, OR 97239, USA.,Joint last authors
| | - Jacob Raber
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR 97239, USA.,Department of Radiation Medicine, Oregon Health and Science University, Portland, OR 97239, USA.,Department of Neurology and Division of Neuroscience, ONPRC, Oregon Health and Science University, Portland, OR 97239, USA.,Joint last authors
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8
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Park JY, Lengacher CA, Reich RR, Park HY, Whiting J, Nguyen AT, Rodríguez C, Meng H, Tinsley S, Chauca K, Gordillo-Casero L, Wittenberg T, Joshi A, Lin K, Ismail-Khan R, Kiluk JV, Kip KE. Translational Genomic Research: The Association between Genetic Profiles and Cognitive Functioning or Cardiac Function Among Breast Cancer Survivors Completing Chemotherapy. Biol Res Nurs 2022; 24:433-447. [PMID: 35499926 PMCID: PMC9630728 DOI: 10.1177/10998004221094386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Emerging evidence suggests that Chemotherapy (CT) treated breast cancer survivors (BCS) who have "risk variants" in genes may be more susceptible to cognitive impairment (CI) and/or poor cardiac phenotypes. The objective of this preliminary study was to examine whether there is a relationship between genetic variants and objective/subjective cognitive or cardiac phenotypes. Methods and Analysis: BCS were recruited from Moffitt Cancer Center, Morsani College of Medicine, AdventHealth Tampa and Sarasota Memorial Hospital. Genomic DNA were collected at baseline for genotyping analysis. A total of 16 single nucleotide polymorphisms (SNPs) from 14 genes involved in cognitive or cardiac function were evaluated. Three genetic models (additive, dominant, and recessive) were used to test correlation coefficients between genetic variants and objective/subjective measures of cognitive functioning and cardiac outcomes (heart rate, diastolic blood pressure, systolic blood pressure, respiration rate, and oxygen saturation). Results: BCS (207 participants) with a mean age of 56 enrolled in this study. The majority were non-Hispanic white (73.7%), married (63.1%), and received both CT and radiation treatment (77.3%). Three SNPs in genes related to cognitive functioning (rs429358 in APOE, rs1800497 in ANKK1, rs10119 in TOMM40) emerged with the most consistent significant relationship with cognitive outcomes. Among five candidate SNPs related to cardiac functioning, rs8055236 in CDH13 and rs1801133 in MTHER emerged with potential significant relationships with cardiac phenotype. Conclusions: These preliminary results provide initial targets to further examine whether BCS with specific genetic profiles may preferentially benefit from interventions designed to improve cognitive and cardiac functioning following CT.
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Affiliation(s)
- Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Richard R. Reich
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Hyun Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Junmin Whiting
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Anh Thy Nguyen
- Department of Epidemiology and
Biostatistics, USF College of Public Health, University of South
Florida, Tampa, FL, USA
| | | | - Hongdao Meng
- School of Aging Studies, College of
Behavioral and Community Sciences, University of South
Floridaa, Tampa, FL, USA
| | - Sara Tinsley
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | | | | | - Anisha Joshi
- University of South Florida College
of Nursing, Tampa, FL, USA
| | - Katherine Lin
- University of South Florida College
of Nursing, Tampa, FL, USA
| | - Roohi Ismail-Khan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - John V. Kiluk
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kevin E. Kip
- UPMC Health Services
Division, Pittsburgh, PA, USA
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9
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Savu DI, Moisoi N. Mitochondria - Nucleus communication in neurodegenerative disease. Who talks first, who talks louder? BIOCHIMICA ET BIOPHYSICA ACTA. BIOENERGETICS 2022; 1863:148588. [PMID: 35780856 DOI: 10.1016/j.bbabio.2022.148588] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/09/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
Mitochondria - nuclear coadaptation has been central to eukaryotic evolution. The dynamic dialogue between the two compartments within the context of multiorganellar interactions is critical for maintaining cellular homeostasis and directing the balance survival-death in case of cellular stress. The conceptualisation of mitochondria - nucleus communication has so far been focused on the communication from the mitochondria under stress to the nucleus and the consequent signalling responses, as well as from the nucleus to mitochondria in the context of DNA damage and repair. During ageing processes this dialogue may be better viewed as an integrated bidirectional 'talk' with feedback loops that expand beyond these two organelles depending on physiological cues. Here we explore the current views on mitochondria - nucleus dialogue and its role in maintaining cellular health with a focus on brain cells and neurodegenerative disease. Thus, we detail the transcriptional responses initiated by mitochondrial dysfunction in order to protect itself and the general cellular homeostasis. Additionally, we are reviewing the knowledge of the stress pathways initiated by DNA damage which affect mitochondria homeostasis and we add the information provided by the study of combined mitochondrial and genotoxic damage. Finally, we reflect on how each organelle may take the lead in this dialogue in an ageing context where both compartments undergo accumulation of stress and damage and where, perhaps, even the communications' mechanisms may suffer interruptions.
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Affiliation(s)
- Diana Iulia Savu
- Department of Life and Environmental Physics, Horia Hulubei National Institute of Physics and Nuclear Engineering, Reactorului 30, P.O. Box MG-6, Magurele 077125, Romania
| | - Nicoleta Moisoi
- Leicester School of Pharmacy, Leicester Institute for Pharmaceutical Innovation, Faculty of Health Sciences, De Montfort University, The Gateway, Hawthorn Building 1.03, LE1 9BH Leicester, UK.
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10
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Oppegaard KR, Armstrong TS, Anguera JA, Kober KM, Debr LK, Laister RC, Saligan LN, Ayala AP, Kuruvilla J, Alm MW, Byker WH, Miaskowski C, Mayo SJ. Blood-Based Biomarkers of Cancer-Related Cognitive Impairment in Non-Central Nervous System Cancer: A Scoping Review. Crit Rev Oncol Hematol 2022; 180:103822. [PMID: 36152911 DOI: 10.1016/j.critrevonc.2022.103822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
This scoping review was designed to synthesize the extant literature on associations between subjective and/or objective measures of cancer-related cognitive impairment (CRCI) and blood-based biomarkers in adults with non-central nervous system cancers. The literature search was done for studies published from the start of each database searched (i.e., MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, grey literature) through to October 20, 2021. A total of 95 studies are included in this review. Of note, a wide variety of biomarkers were evaluated. Most studies evaluated patients with breast cancer. A variety of cognitive assessment measures were used. The most consistent significant findings were with various subjective and objective measures of CRCI and levels of interleukin-6 and tumor necrosis factor. Overall, biomarker research is in an exploratory phase. However, this review synthesizes findings and proposes directions for future research.
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Affiliation(s)
- Kate R Oppegaard
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, USA
| | - Joaquin A Anguera
- University of California San Francisco, Department of Neurology and Psychiatry, USA
| | - Kord M Kober
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Lynch Kelly Debr
- University of Florida, College of Nursing, USA; University of Florida Health Cancer Center, USA
| | - Rob C Laister
- Princess Margaret Health Center, University Health Network, Canada
| | - Leorey N Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institutes of Health, USA
| | | | - John Kuruvilla
- Princess Margaret Health Center, University Health Network, Canada
| | - Mark W Alm
- Toronto General Hospital, University Health Network, Canada
| | | | - Christine Miaskowski
- University of California San Francisco, School of Medicine, Department of Anesthesia and Perioperative Care, USA
| | - Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada.
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Haggstrom LR, Vardy JL, Carson EK, Segara D, Lim E, Kiely BE. Effects of Endocrine Therapy on Cognitive Function in Patients with Breast Cancer: A Comprehensive Review. Cancers (Basel) 2022; 14:cancers14040920. [PMID: 35205665 PMCID: PMC8870664 DOI: 10.3390/cancers14040920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Many persons diagnosed with breast cancer are treated with endocrine therapy and will experience the side effects of endocrine therapy. Cognitive adverse effects of endocrine therapy are increasingly being recognised, and can significantly affect quality of life, adherence and treatment outcome. This review aims to discuss the nature of cognitive dysfunction associated with endocrine therapy, the mechanisms underpinning its development, and evidence-based management strategies. Abstract Endocrine therapy forms the backbone of systemic therapy for the majority of persons with early and late-stage breast cancer. However, the side effects can negatively affect quality of life, and impact treatment adherence and overall oncological outcomes. Adverse effects on cognition are common, underreported and challenging to manage. We aim to describe the nature, incidence, risk factors and underlying mechanisms of endocrine therapy-induced cognitive dysfunction. We conducted a comprehensive literature review of the studies reporting on cognitive dysfunction associated with endocrine therapies for breast cancer. We also summarise prevention and treatment strategies, and ongoing research. Given that patients are taking endocrine therapies for longer durations than ever before, it is essential that these side effects are managed pro-actively within a multi-disciplinary team in order to promote adherence to endocrine therapy and improve patients’ quality of life.
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Affiliation(s)
- Lucy R. Haggstrom
- Campbelltown Hospital, Therry Road, Campbelltown, NSW 2560, Australia; (L.R.H.); (E.-K.C.)
| | - Janette L. Vardy
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia;
- Concord Cancer Centre, Concord Repatriation and General Hospital, Concord, NSW 2139, Australia
| | - Emma-Kate Carson
- Campbelltown Hospital, Therry Road, Campbelltown, NSW 2560, Australia; (L.R.H.); (E.-K.C.)
- Concord Clinical School, University of Sydney, Concord, NSW 2139, Australia
| | - Davendra Segara
- St Vincent’s Clinical School, University of New South Wales, Darlinghurst, NSW 2010, Australia;
| | - Elgene Lim
- St Vincent’s Clinical School, University of New South Wales, Darlinghurst, NSW 2010, Australia;
- Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia
- Correspondence: (E.L.); (B.E.K.)
| | - Belinda E. Kiely
- Campbelltown Hospital, Therry Road, Campbelltown, NSW 2560, Australia; (L.R.H.); (E.-K.C.)
- Concord Clinical School, University of Sydney, Concord, NSW 2139, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW 2050, Australia
- Correspondence: (E.L.); (B.E.K.)
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Lyu YR, Lee HY, Park HJ, Kwon OJ, Kim AR, Jung IC, Park YC, Cho JH, Kim JE, Kim M, Lee JH, Kim JH. Electroacupuncture for Cancer-Related Cognitive Impairment: A Clinical Feasibility Study. Integr Cancer Ther 2022; 21:15347354221098983. [PMID: 35608027 PMCID: PMC9134458 DOI: 10.1177/15347354221098983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/20/2022] [Accepted: 04/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) is a significant problem for cancer patients, as the number of cancer survivors experiencing cognitive impairments is increasing in the absence of standard treatment. There have been attempts to improve the cognitive function of patients with cancer using acupuncture; however, no studies have been conducted using electroacupuncture. Thus, we designed a preliminary study to investigate the feasibility of a clinical trial using electroacupuncture in CRCI patients. METHODS We conducted a single-arm, pilot, clinical trial to investigate the feasibility of a study protocol for further large-scale clinical trials of electroacupuncture in CRCI patients. All participants were treated with electroacupuncture twice a week for 30 minutes at a time, for 8 weeks on acupoints GV20, GV24, EX-HN1, and GB20, HT7, PC6, and KI3. Both subjective and objective outcomes of cognitive function, quality of life (QoL), and psychological factors were measured in all participants at baseline, week 4, 8, and 12. For safety assessment, vital signs, laboratory examinations, and adverse events (AEs) were observed throughout the trial. RESULTS A total of 12 participants were enrolled at Daejeon and Dunsan Korean Medicine Hospital of Daejeon University from 21 April 2017 to 31 January 2018. After 8 weeks of treatment, electroacupuncture significantly improved both subjective and objective cognitive outcomes, including the perceived cognitive impairments scale of the Functional Assessment of Cancer Therapy-Cognitive Function, QoL scale of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire-C30, Korean version of Montreal Cognitive Assessment, Boston Naming Test, Seoul Verbal Learning Test, and Rey Complex Figure Test. During the entire trial period, 19 AEs were observed, with no serious AEs. Additionally, it was found that all feasibility outcomes, including recruitment, completion, and adherence rates, achieved successful results as the ratio exceeded 0.8. CONCLUSION Our study results revealed that electroacupuncture improved cognitive complaints in cancer patients, and we expect electroacupuncture to be a safe and effective management therapy for CRCI patients. These feasibility trial results will be used as preliminary data for future randomized controlled clinical trials. TRIAL REGISTRATION NUMBER Korean Clinical Trial Registry (KCT0002168).
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Affiliation(s)
- Yee Ran Lyu
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | - Hye-Yoon Lee
- Pusan National University, Yangsan,
Republic of Korea
| | - Hyo-Ju Park
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | - O-jin Kwon
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
| | | | | | | | - Jung-Eun Kim
- Pusan National University Hospital,
Busan, Republic of Korea
| | - Mikyung Kim
- Sangji University, Wonju, Gangwon-do,
Republic of Korea
| | - Jun-Hwan Lee
- Korea Institute of Oriental Medicine,
Daejeon, Republic of Korea
- University of Science & Technology
(UST) Daejeon, Republic of Korea
| | - Joo-Hee Kim
- Sangji University, Wonju, Gangwon-do,
Republic of Korea
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Mitochondrial DNA and Alzheimer's disease: a first case-control study of the Tunisian population. Mol Biol Rep 2021; 49:1687-1700. [PMID: 34854014 DOI: 10.1007/s11033-021-06978-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common neurodegenerative disorder in humans and presents a major health problem throughout the world. The etiology of AD is complex, and many factors are implicated, including mitochondria. Mitochondrial alteration has been proposed as a possible cause of AD. Therefore, several studies have focused on finding an association between inherited mitochondrial DNA variants and AD onset. METHODS In this study, we looked, for the first time, for a potential association between mitochondrial haplogroups or polymorphisms and AD in the Tunisian population. We also evaluated the distribution of the major genetic risk factor for AD, the apolipoprotein E epsilon 4 (APOE ε4), in this population. In total, 159 single-nucleotide polymorphisms (SNPs) of mitochondrial DNA haplogroups were genotyped in 254 individuals (58 patients and 196 controls). An additional genotyping of APOE ε4 was performed. RESULTS No significant association between mitochondrial haplogroups and AD was found. However, two individual SNPs, A5656G (p = 0.03821, OR = 10.46) and A13759G (p = 0.03719, OR = 10.78), showed a significant association with AD. APOE 4 was confirmed as a risk factor for AD (p = 0.000014). CONCLUSION Our findings may confirm the absence of a relation between mitochondrial haplogroups and AD and support the possible involvement of some inherited variants in the pathogenicity of AD.
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Van Dyk K, Crespi CM, Bower JE, Carroll JE, Petersen L, Ganz PA. Association of APOE4 genotype and treatment with cognitive outcomes in breast cancer survivors over time. NPJ Breast Cancer 2021; 7:112. [PMID: 34480030 PMCID: PMC8417038 DOI: 10.1038/s41523-021-00327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/26/2021] [Indexed: 11/09/2022] Open
Abstract
This prospective longitudinal study of breast cancer survivors (n = 167) examined the association of apolipoprotein ε4 (APOE ε4) genotype with cognition and interactions with chemotherapy or endocrine therapy up to 6 years after treatment. In general, we found no effects of ε4 across timepoints and treatment exposures; post hoc analysis at 3-6 years suggested a trend towards worse cognition in the domains of attention and learning among ε4 carriers exposed to endocrine therapy. Further study is needed.
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Affiliation(s)
- Kathleen Van Dyk
- Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Julienne E Bower
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
- Department of Psychology, UCLA, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Judith E Carroll
- Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, USA.
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
- Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.
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Brief relaxation training is associated with long-term endocrine therapy adherence among women with breast cancer: post hoc analysis of a randomized controlled trial. Breast Cancer Res Treat 2021; 190:79-88. [PMID: 34410568 DOI: 10.1007/s10549-021-06361-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 08/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Despite life-saving potential, many women struggle to adhere to adjuvant endocrine therapy (AET) for their breast cancer (BCa). Prior research has demonstrated that emotional distress is a barrier to AET adherence. We followed women from a trial to test the long-term effects of two 5-week post-surgical group-based stress management interventions, cognitive behavioral therapy (CBT), and relaxation training versus an attention-matched health education control, on AET adherence. METHODS We conducted a long-term follow-up (median = 8 years) of women randomized to CBT, relaxation training, or health education after surgery for stage 0-3 BCa. We measured adherence with the Endocrine Therapy Medication Usage Questionnaire (ETMUQ). First, we established factors on the ETMUQ via confirmatory factor analysis. We then used Bayesian structural equation modeling to regress these factors on study arm, controlling for age and treatments received. RESULTS Of those who completed long-term follow-up (n = 59, 44.7%), over half (n = 33; 55.9%) reported problems with adherence generally. Women receiving relaxation training (n = 15) had better adherence than those receiving health education (n = 24) on the Forgetfulness/Inconsistency [B(SE) = 0.25(0.14), p = 0.049] and Intentional Nonadherence [B(SE) = 0.31(0.14), p = 0.018] factors of the ETMUQ. Similar results were observed for those receiving relaxation training compared to CBT (n = 20): Forgetfulness/Inconsistency [B(SE) = - 0.47(0.25), p = 0.031]; Intentional Nonadherence [B(SE) = - 0.31(0.15), p = 0.027]. CONCLUSION Women receiving relaxation training were less likely to (1) forget to take their AET and (2) intentionally miss doses of AET in the long term compared to women receiving health education or CBT. This is evidence for the need of randomized trials that aim to improve adherence by incorporating theoretically based behavioral change techniques. TRIAL REGISTRATION AND DATES Trial 2R01-CA-064710 was registered March 26, 2006.
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Syed Alwi SM, Narayanan V, Mohd Taib NA, Che Din N. Chemotherapy-related cognitive impairment (CRCI) among early-stage breast cancer survivors in Malaysia. J Clin Exp Neuropsychol 2021; 43:534-545. [PMID: 34369307 DOI: 10.1080/13803395.2021.1945539] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Breast cancer survivors frequently develop cognitive impairment following chemotherapy which can significantly hamper their well-being, ability to function independently, and overall quality of life. Evidence of cognitive functioning in breast cancer survivors from lower and middle-income countries remains scarce. We examined the prevalence of cognitive impairment among Malaysian multiethnic early-stage breast cancer survivors one to three years post-chemotherapy.Methods: This cross-sectional study included 160 breast cancer survivors from the University Malaya Medical Center (UMMC). The cognitive assessments used included the Montreal Cognitive Assessment (MoCA-BM), the Rey Auditory and Verbal Learning Test (RAVLT-BM), and the digit span and arithmetic of the Working Memory Index (WMI) of Wechsler Adult Intelligence Scale-IV (WAIS-IV). Data were analyzed using independent sample t-tests and Pearson's correlation.Results: Our breast cancer survivors demonstrated poor performances in MoCA-BM (31.9%) RAVLT-BM, recall (53.8%), and WMI of WAIS-IV (51.3%) with 30.6% of them performed poorly in all three cognitive tests administered. There were no significant mean group differences in cognitive performances between <24 months after chemotherapy and ≥24 months after chemotherapy.Conclusions: A high proportion of breast cancer survivors exhibited poor performances in the cognitive assessments. Cognitive rehabilitation programmes tailored to the needs of these survivors should be incorporated into cancer care management.
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Affiliation(s)
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Normah Che Din
- School of Healthcare Sciences, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Boerma M, Davis CM, Jackson IL, Schaue D, Williams JP. All for one, though not one for all: team players in normal tissue radiobiology. Int J Radiat Biol 2021; 98:346-366. [PMID: 34129427 PMCID: PMC8781287 DOI: 10.1080/09553002.2021.1941383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/27/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE As part of the special issue on 'Women in Science', this review offers a perspective on past and ongoing work in the field of normal (non-cancer) tissue radiation biology, highlighting the work of many of the leading contributors to this field of research. We discuss some of the hypotheses that have guided investigations, with a focus on some of the critical organs considered dose-limiting with respect to radiation therapy, and speculate on where the field needs to go in the future. CONCLUSIONS The scope of work that makes up normal tissue radiation biology has and continues to play a pivotal role in the radiation sciences, ensuring the most effective application of radiation in imaging and therapy, as well as contributing to radiation protection efforts. However, despite the proven historical value of preclinical findings, recent decades have seen clinical practice move ahead with altered fractionation scheduling based on empirical observations, with little to no (or even negative) supporting scientific data. Given our current appreciation of the complexity of normal tissue radiation responses and their temporal variability, with tissue- and/or organ-specific mechanisms that include intra-, inter- and extracellular messaging, as well as contributions from systemic compartments, such as the immune system, the need to maintain a positive therapeutic ratio has never been more urgent. Importantly, mitigation and treatment strategies, whether for the clinic, emergency use following accidental or deliberate releases, or reducing occupational risk, will likely require multi-targeted approaches that involve both local and systemic intervention. From our personal perspective as five 'Women in Science', we would like to acknowledge and applaud the role that many female scientists have played in this field. We stand on the shoulders of those who have gone before, some of whom are fellow contributors to this special issue.
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Affiliation(s)
- Marjan Boerma
- Division of Radiation Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Catherine M. Davis
- Department of Pharmacology and Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Isabel L. Jackson
- Division of Translational Radiation Sciences, Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dörthe Schaue
- Department of Radiation Oncology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Jacqueline P. Williams
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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Butterbrod E, Sitskoorn M, Bakker M, Jakobs B, Fleischeuer R, Roijers J, Rutten G, Gehring K. The APOE ε4 allele in relation to pre- and postsurgical cognitive functioning of patients with primary brain tumors. Eur J Neurol 2021; 28:1665-1676. [PMID: 33342004 PMCID: PMC8247965 DOI: 10.1111/ene.14693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recent studies suggest a relationship between the APOE ε4 allele and cognitive outcome in patients treated for malignant brain tumors. Still, longitudinal investigations that include a pretreatment cognitive assessment are lacking and APOE's effects in patients with benign tumors are understudied. This study investigated presurgical cognitive performance and postsurgical change in ε4-carrying and non-carrying patients with glioma and meningioma. METHODS Neuropsychological test scores (CNS Vital Signs battery [seven measures], Digit Span Forward/Backward, Letter Fluency test) were obtained as part of a prospective study in which patients with meningioma and glioma underwent cognitive assessment 1 day before (T0, n = 505) and 3 (T3, n = 418) and 12 months after (T12, n = 167) surgery. APOE isoforms were identified retrospectively. ε4 carriers and non-carriers were compared with regard to pretreatment cognitive performance on the group and individual level. Changes in performances over time were compared with longitudinal mixed model analysis in the total sample and the subgroup receiving adjuvant treatment. RESULTS Carriers and non-carriers did not differ with regard to pretreatment performance. No significant main effect of ε4 carrier status or interaction between time (T0-T12) and carrier status was found on any of the tests in the whole sample nor in the sample receiving adjuvant treatment. CONCLUSIONS This study found no evidence of increased vulnerability for pretreatment cognitive dysfunction or cognitive decline within 1 year after surgery in APOE ε4-carrying meningioma and glioma patients. Investigations that include larger samples at longer-term follow-up are recommended to investigate potential late treatment effects.
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Affiliation(s)
- Elke Butterbrod
- Department of Cognitive NeuropsychologyTilburg UniversityTilburgThe Netherlands
| | - Margriet Sitskoorn
- Department of Cognitive NeuropsychologyTilburg UniversityTilburgThe Netherlands
| | - Marjan Bakker
- Department of Methodology and StatisticsTilburg UniversityTilburgThe Netherlands
| | - Bernadette Jakobs
- Department of Laboratory MedicineElisabeth‐Tweesteden HospitalTilburgThe Netherlands
| | - Ruth Fleischeuer
- Clinical Pathology LaboratoryElisabeth‐Tweesteden HospitalTilburgThe Netherlands
| | - Janine Roijers
- Department of Laboratory MedicineElisabeth‐Tweesteden HospitalTilburgThe Netherlands
| | - Geert‐Jan Rutten
- Department of NeurosurgeryElisabeth‐Tweesteden HospitalTilburgThe Netherlands
| | - Karin Gehring
- Department of Cognitive NeuropsychologyTilburg UniversityTilburgThe Netherlands
- Department of NeurosurgeryElisabeth‐Tweesteden HospitalTilburgThe Netherlands
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Bai L, Yu E. A narrative review of risk factors and interventions for cancer-related cognitive impairment. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:72. [PMID: 33553365 PMCID: PMC7859819 DOI: 10.21037/atm-20-6443] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Cancer-related cognitive impairment (CRCI) refers to a series of cognitive impairment symptoms associated with alternations in brain structure and function, caused by a non-central nervous system malignant tumor and its related treatment. CRCI may present as memory loss, impaired concentration, difficulty in multitasking and word retrieval, and reduced comprehension speed. CRCI has become one of the prevalent factors that compromise the quality of life for cancer survivors. Different treatments, including surgery, chemotherapy, radiotherapy, endocrine therapy, and targeted drugs, may contribute to CRCI. Meanwhile, patients’ factors, including emotional challenges and genetic makeup, also contribute to the development of CRCI. The condition can be treated with using stimulants methylphenidate and modafinil, metabolites of nicotine: cotinine, antidepressants of fluoxetine and fluvoxamine, dementia drug of donepezil, and antioxidants ZnSO4, n-acetyl cysteine, propofol, and Chinese herbal of silver leaf medicine. Psychotherapies, including meditation and relaxation, cognitive rehabilitation training, along with physical therapies, including aerobic exercise, resistance training, balance training, yoga, qigong, tai chi electroencephalogram biofeedback, and acupuncture, are also beneficial in alleviating cancer-related cognitive impairment symptoms. In recent years, researchers have focused on factors related to the condition and on the available interventions. However, most research was conducted independently, and no review has yet summarized the latest findings. This review details and discusses the status of related factors and potential treatments for CRCI. We also supply specific recommendations to facilitate future research and integration in this field.
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Affiliation(s)
- Lu Bai
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Beijing, China
| | - Enyan Yu
- Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Beijing, China
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Jia M, Zhang X, Wei L, Gao J. Measurement, outcomes and interventions of cognitive function after breast cancer treatment: A narrative review. Asia Pac J Clin Oncol 2020; 17:321-329. [PMID: 33079484 DOI: 10.1111/ajco.13484] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 09/19/2020] [Indexed: 11/29/2022]
Abstract
Cancer-related cognitive impairment (CRCI) is a common complaint in breast cancer patients, especially related to chemotherapy. It is characterized as cognitive disorders in areas of memory, attention and executive function, which can negatively affect patients' quality of life and their ability to work. While various assessment methods of CRCI cause highly diverse results in CRCI-related studies. Currently, it is not clear how cerebral structure and function change in breast cancer patients and underlying mechanisms of developing CRCI are still undefined. Intervention research is limited. This article reviews the results of CRCI-related studies and research progress and discusses the advantages and limits of various methods. Besides, the mechanisms and intervention strategies are reviewed.
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Affiliation(s)
- Miaomiao Jia
- Department of Breast Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Xiaojun Zhang
- Department of Breast Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Liyuan Wei
- Department of Breast Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
| | - Jinnan Gao
- Department of Breast Surgery, Shanxi Bethune Hospital, Taiyuan, Shanxi, China
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Li W, Zhao J, Ding K, Chao HH, Li CSR, Cheng H, Shen L. Catechol-O-Methyltransferase Gene Polymorphisms and the Risk of Chemotherapy-Induced Prospective Memory Impairment in Breast Cancer Patients with Varying Tumor Hormonal Receptor Expression. Med Sci Monit 2020; 26:e923567. [PMID: 32985495 PMCID: PMC7531203 DOI: 10.12659/msm.923567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Existing research evidence indicates that breast cancer patients have different degrees of cognitive dysfunction after chemotherapy, and polymorphisms in 3 genes (catechol-O-methyltransferase, COMT; apolipoprotein E, APOE; and brain-derived neurotrophic factor, BDNF) have been associated with cognitive impairment. However, the role of these 3 gene polymorphisms in modulating cognitive impairment in breast cancer survivors with varying hormonal receptor expression is not clear at present. To explore the effects of genetic polymorphisms in BDNF, APOE, and COMT on the regulation of prospective memory impairments induced by chemotherapy in breast cancer patients with various expression levels of estrogen receptor (ER) and progesterone receptor (PR). Material/Methods A total of 232 patients with breast cancer (113 with ER−/PR− and 119 with ER+/PR+) were evaluated before and after chemotherapy for cognitive function, including prospective memory. Following previously published sequencing procedures, we assessed 6 single-nucleotide polymorphisms (SNPs), including BDNF (rs6265), APOE (rs429358, rs7412), and COMT (rs165599, rs4680, rs737865). Results The patients showed poorer prospective memory scores after chemotherapy than before chemotherapy. Furthermore, the ER−/PR− group showed poorer event-based prospective memory (EBPM) scores than the ER+/PR+ group (z=−7.831, p<0.01) after chemotherapy. The patients with the COMT rs737865G/G genotype, compared with those with the A/A and A/G genotypes, showed a linear EBPM performance (β=1.499, 95% confidence interval (CI)=1.017~2.211) and were less likely to have memory impairment. In contrast, APOE and BDNF polymorphisms did not influence cognitive performance. Conclusions The patterns of hormonal receptor expression may be related to prospective memory impairments induced by chemotherapy in breast cancer patients. Furthermore, the COMT polymorphism (rs737865) was linearly related to the extent of deficits in EBPM and may represent a potential genetic marker of risk for cognitive deficits triggered by chemotherapy in patients with breast cancer.
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Affiliation(s)
- Wen Li
- Cancer Hospital, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China (mainland)
| | - Jingjing Zhao
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Ke Ding
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Herta H Chao
- Cancer Center, VA Connecticut Healthcare System, New Haven, CT, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Huaidong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Li Shen
- Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China (mainland)
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22
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Johnson LA. APOE and metabolic dysfunction in Alzheimer's disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 154:131-151. [PMID: 32739002 DOI: 10.1016/bs.irn.2020.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The strongest genetic risk factor for sporadic Alzheimer's disease (AD) is carriage of the E4 allele of APOE. Metabolic dysfunction also increases risk of dementia and AD. Facing a need for effective therapies and an aging global population, studies aimed at uncovering new therapeutic targets for AD have become critical. Insight into the biology underlying the effects of E4 and metabolic impairment on the brain may lead to novel therapies to reduce AD risk. An understudied hallmark of both AD patients and E4 individuals is a common metabolic impairment-cerebral glucose hypometabolism. This is a robust and replicated finding in humans, and begins decades prior to cognitive decline. Possession of E4 also appears to alter several other aspects of cerebral glucose metabolism, fatty acid metabolism, and management of oxidative stress through the pentose phosphate pathway. A critical knowledge gap in AD is the mechanism by which APOE alters cerebral metabolism and clarification as to its relevance to AD risk. Facing a need for effective therapies, studies aimed at uncovering new therapeutic targets have become critical. One such approach is to gain a better understanding of the metabolic mechanisms that may underlie E4-associated cognitive dysfunction and AD risk.
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Affiliation(s)
- Lance A Johnson
- Department of Physiology, University of Kentucky College of Medicine, Lexington, KY, United States; Sanders-Brown Center on Aging, University of Kentucky College of Medicine, Lexington, KY, United States.
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23
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Lange M, Joly F, Vardy J, Ahles T, Dubois M, Tron L, Winocur G, De Ruiter M, Castel H. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Ann Oncol 2019; 30:1925-1940. [PMID: 31617564 PMCID: PMC8109411 DOI: 10.1093/annonc/mdz410] [Citation(s) in RCA: 292] [Impact Index Per Article: 58.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Advances in diagnostic and therapeutic strategies in oncology have significantly increased the chance of survival of cancer patients, even those with metastatic disease. However, cancer-related cognitive impairment (CRCI) is frequently reported in patients treated for non-central nervous system cancers, particularly during and after chemotherapy. DESIGN This review provides an update of the state of the art based on PubMed searches between 2012 and March 2019 on 'cognition', 'cancer', 'antineoplastic agents' or 'chemotherapy'. It includes the most recent clinical, imaging and pre-clinical data and reports management strategies of CRCI. RESULTS Evidence obtained primarily from studies on breast cancer patients highlight memory, processing speed, attention and executive functions as the most cognitive domains impaired post-chemotherapy. Recent investigations established that other cancer treatments, such as hormone therapies and targeted therapies, can also induce cognitive deficits. Knowledge regarding predisposing factors, biological markers or brain functions associated with CRCI has improved. Factors such as age and genetic polymorphisms of apolipoprotein E, catechol-O-methyltransferase and BDNF may predispose individuals to a higher risk of cognitive impairment. Poor performance on neuropsychological tests were associated with volume reduction in grey matter, less connectivity and activation after chemotherapy. In animals, hippocampus-based memory and executive functions, mediated by the frontal lobes, were shown to be particularly susceptible to the effects of chemotherapy. It involves altered neurogenesis, mitochondrial dysfunction or brain cytokine response. An important next step is to identify strategies for managing cognitive difficulties, with primary studies to assess cognitive training and physical exercise regimens. CONCLUSIONS CRCI is not limited to chemotherapy. A multidisciplinary approach has improved our knowledge of the complex mechanisms involved. Nowadays, studies evaluating cognitive rehabilitation programmes are encouraged to help patients cope with cognitive difficulties and improve quality of life during and after cancer.
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Affiliation(s)
- M. Lange
- INSERM, U1086, ANTICIPE, 14000 Caen,Clinical Research Department, Centre François Baclesse, 14000 Caen,Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen
| | - F. Joly
- INSERM, U1086, ANTICIPE, 14000 Caen,Clinical Research Department, Centre François Baclesse, 14000 Caen,Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen,Medical Oncology Department, CHU de Caen, 14000 Caen, France,Correspondence to: Prof. Florence Joly, Medical Oncology Department, Inserm U1086 Anticipe, Centre François Baclesse, 3 avenue Général Harris, Caen 14000, France. Tel: +33-2-3145-5002;
| | - J Vardy
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, New South Wales,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - T. Ahles
- Neurocognitive Research Lab, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M. Dubois
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen,Normandie University, UNIROUEN, INSERM, DC2N, 76000 Rouen,Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen
| | - L. Tron
- INSERM, U1086, ANTICIPE, 14000 Caen,Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen,CHU de Caen, 14000 Caen, France
| | - G. Winocur
- Baycrest Centre, Rotman Research Institute, Toronto,Department of Psychology, Trent University, Peterborough,Department of Psychology and Psychiatry, University of Toronto, Toronto, Canada
| | - M.B. De Ruiter
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H. Castel
- Cancer and Cognition Platform, Ligue Nationale Contre le Cancer, 14000 Caen,Normandie University, UNIROUEN, INSERM, DC2N, 76000 Rouen,Institute for Research and Innovation in Biomedicine (IRIB), 76000 Rouen
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24
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Huehnchen P, van Kampen A, Boehmerle W, Endres M. Cognitive impairment after cytotoxic chemotherapy. Neurooncol Pract 2019; 7:11-21. [PMID: 32257280 DOI: 10.1093/nop/npz052] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Neurotoxicity is a frequent side effect of cytotoxic chemotherapy and affects a large number of patients. Despite the high medical need, few research efforts have addressed the impact of cytotoxic agents on cognition (ie, postchemotherapy cognitive impairment; PCCI). One unsolved question is whether individual cytotoxic drugs have differential effects on cognition. We thus examine the current state of research regarding PCCI. Neurological symptoms after targeted therapies and immunotherapies are not part of this review. Methods A literature search was conducted in the PubMed database, and 1215 articles were reviewed for predefined inclusion and exclusion criteria. Thirty articles were included in the systematic review. Results Twenty-five of the included studies report significant cognitive impairment. Of these, 21 studies investigated patients with breast cancer. Patients mainly received combinations of 5-fluorouracil, epirubicin, cyclophosphamide, doxorubicin, and taxanes (FEC/FEC-T). Five studies found no significant cognitive impairment in chemotherapy patients. Of these, 2 studies investigated patients with colon cancer receiving 5-fluorouracil and oxaliplatin (FOLFOX). Independent risk factors for PCCI were patient age, mood alterations, cognitive reserve, and the presence of apolipoprotein E e4 alleles. Conclusions There is evidence that certain chemotherapy regimens cause PCCI more frequently than others as evidenced by 21 out of 23 studies in breast cancer patients (mainly FEC-T), whereas 2 out of 3 studies with colon cancer patients (FOLFOX) did not observe significant changes. Further studies are needed defining patient cohorts by treatment protocol in addition to cancer type to elucidate the effects of individual cytotoxic drugs on cognitive functions.
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Affiliation(s)
- Petra Huehnchen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Cluster of Excellence NeuroCure, Germany.,Berlin Institute of Health, Germany
| | - Antonia van Kampen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Germany
| | - Wolfgang Boehmerle
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Cluster of Excellence NeuroCure, Germany
| | - Matthias Endres
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik und Hochschulambulanz für Neurologie, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Cluster of Excellence NeuroCure, Germany.,Berlin Institute of Health, Germany.,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Stroke Research Berlin, Germany.,German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.,DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany
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25
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Sleurs C, Lemiere J, Radwan A, Verly M, Elens I, Renard M, Jacobs S, Sunaert S, Deprez S, Uyttebroeck A. Long-term leukoencephalopathy and neurocognitive functioning in childhood sarcoma patients treated with high-dose intravenous chemotherapy. Pediatr Blood Cancer 2019; 66:e27893. [PMID: 31276297 DOI: 10.1002/pbc.27893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Knowledge is limited regarding the prevalence and persistence of chemotherapy-induced leukoencephalopathy in childhood sarcoma patients. This study explored the presence, clinical relevance, and potential risk factors of leukoencephalopathy in childhood bone and soft tissue sarcoma survivors, treated with intravenous chemotherapy. METHODS We acquired cross-sectional neurocognitive data in adult survivors (n = 34) (median age at diagnosis [AaD] = 13.32 years, age range = 16-35 years) and healthy age-matched controls (n = 34). Additionally, magnetic resonance imaging included T2-weighted FLAIR (leukoencephalopathy Fazekas rating), multiexponential T2 relaxation (MET2), and multishell diffusion MRI to estimate myelin integrity-related metrics and fluid movement restrictions. Finally, chemotherapy subgroups (methotrexate, alkylating agents, or combination), AaD, and Apoε and MTHFRC677T polymorphisms were explored as potential risk factors for leukoencephalopathy. RESULTS At the group level, quality of life, working memory, processing speed, and visual memory were significantly lower in patients compared to controls. Furthermore, long-term leukoencephalopathy was observed in 27.2% of the childhood sarcoma survivors, which was related to attentional processing speed. Lesions were related to diffusion-derived, but not to myelin-sensitive metrics. A significant interaction effect between AaD and chemotherapy group demonstrated more lesions in case of high-dose methotrexate (HD-MTX) (F = 3.434, P = .047). However, patients treated with alkylating agents (without HD-MTX) also showed lesions in younger patients. Genetic predictors were nonsignificant. CONCLUSION AND IMPLICATION This study suggests long-term leukoencephalopathy with possibly underlying changes in vasculature, inflammation, or axonal injury, but not necessarily long-term demyelination. Such lesions could affect processing speed, and as such long-term daily life functioning of these patients.
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Affiliation(s)
- Charlotte Sleurs
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Ahmed Radwan
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Iris Elens
- Department of Biological Psychology, KU Leuven, Belgium
| | - Marleen Renard
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Sabine Deprez
- Department of Radiology, University Hospital Leuven, Leuven, Belgium
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
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26
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Park JY, Lengacher CA, Reich RR, Alinat CB, Ramesar S, Le A, Paterson CL, Pleasant ML, Park HY, Kiluk J, Han H, Ismail-Khan R, Kip KE. Translational genomic research: the role of genetic polymorphisms in MBSR program among breast cancer survivors (MBSR[BC]). Transl Behav Med 2019; 9:693-702. [PMID: 30137607 DOI: 10.1093/tbm/iby061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Genetic variations of breast cancer survivors (BCS) may contribute to level of residual symptoms, such as depression, stress, fatigue, and cognitive impairment. The objective of this study was to investigate whether particular single-nucleotide polymorphisms (SNPs) moderated symptom improvement resulting from the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program. An overarching goal of personalized medicine is to identify individuals as risk for disease and tailor interventions based on genetic profiles of patients with diseases including cancer. BCS were recruited from Moffitt Cancer Center and University of South Florida's Breast Health Program and were randomized to either the 6-week MBSR(BC) program (n = 92) or Usual Care (n = 93). Measures of symptoms, demographic, and clinical history data were attained at baseline, 6 weeks, and 12 weeks. A total of 10 SNPs from eight genes known to be related to these symptoms were studied using genomic DNA extracted from blood. Our results were examined for effect sizes, consistency, and statistical significance (p < .05). Three SNPs (rs4680 in COMT, rs6314 in HTR2A, and rs429358 in APOE) emerged as having the strongest (though relatively weak) and most consistent effects in moderating the impact of the MBSR program on symptom outcomes. Although effects were generally weak, with only one effect withstanding multiple comparisons correction for statistical significance, this translational behavioral research may help start the identification of genetic profiles that moderate the impact of MBSR(BC). The ultimate goal of this study is the development of personalized treatment programs tailored to the genetic profile of each patient.
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Affiliation(s)
- Jong Y Park
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Richard R Reich
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Sophia Ramesar
- University of South Florida College of Nursing, Tampa, FL, USA
| | - Alice Le
- University of South Florida College of Nursing, Tampa, FL, USA
| | - Carly L Paterson
- National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | | | - Hyun Y Park
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - John Kiluk
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Hyo Han
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Roohi Ismail-Khan
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Kevin E Kip
- Department of Epidemiology and Biostatistics, University of South Florida, College of Public Health, Tampa, FL, USA
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27
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Bender CM, Merriman JD, Sereika SM, Gentry AL, Casillo FE, Koleck TA, Rosenzweig MQ, Brufsky AM, McAuliffe P, Zhu Y, Conley YP. Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer. Oncol Nurs Forum 2019; 45:308-326. [PMID: 29683114 DOI: 10.1188/18.onf.308-326] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study identified women with unique trajectories of executive function, concentration, and visual working memory before and during adjuvant therapy for breast cancer, and examined phenotypic and genotypic predictors associated with subgroups. SAMPLE & SETTING 399 postmenopausal women, of whom 288 were women with early-stage breast cancer and 111 were women without breast cancer, matched on age and years of education to the women with breast cancer, and all at an urban cancer center. METHODS & VARIABLES A repeated-measures design was used; assessments occurred before adjuvant therapy and every six months post-therapy initiation. Group-based trajectory modeling determined subgroups. Multinomial logistic regression identified phenotypic and genotypic characteristics. RESULTS Three executive function and concentration trajectory subgroups were identified. IMPLICATIONS FOR NURSING Advancing age, greater pretherapy fatigue, and poorer pretherapy cognitive function are associated with the low subgroups. DNA repair and oxidative stress mechanisms may be involved in the cognitive changes that women experience.
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Affiliation(s)
| | | | - Susan M Sereika
- Associate professors School of Nursing, University of Pittsburgh, Pennsylvania
| | - Amanda L Gentry
- Department of Health and Community Systems, School of Medicine
| | - Frances E Casillo
- Department of Acute and Tertiary Care, Office of Community Partnerships
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28
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Buskbjerg CDR, Amidi A, Demontis D, Nissen ER, Zachariae R. Genetic risk factors for cancer-related cognitive impairment: a systematic review. Acta Oncol 2019; 58:537-547. [PMID: 30822178 DOI: 10.1080/0284186x.2019.1578410] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Cancer-related cognitive impairment (CRCI) is a commonly reported complaint among non-CNS cancer patients. Even subtle CRCI may have detrimental effects on quality of life and identifying patients at increased risk for CRCI to improve survivorship care is important. In the present paper, we systematically reviewed available studies of possible genetic risk factors for developing CRCI. Methods: Keyword-based systematic searches were undertaken on 24 July 2018 in PubMed, Web of Science, The Cochrane Library, and CINAHL. Three authors independently evaluated full-texts of identified papers and excluded studies with registration of reasons. Seventeen studies reporting results from 14 independent samples were included for review. Two authors independently quality assessed the included studies. The review was preregistered with PROSPERO (CRD42018107689). Results: Ten studies investigated apolipoprotein E (APOE), with four studies reporting that carrying at least one risk allele (APOE4 (ε4)) was associated with CRCI, while six studies found no association. The remaining identified genetic risk variants associated with CRCI located in: COMT, four DNA repair genes, five oxidative stress genes, 22 genes related to breast cancer phenotype, and GNB3. No associations were found between CRCI and genes coding for interleukin-6 (IL6), tumor necrosis factor alpha (TNF), interleukin 1 beta (IL1B), and brain-derived neurotropic factor (BDNF). With the exception of APOE, the genetic risk factors had only been investigated in one or two studies each. Conclusions: Overall, the available evidence of possible genetic risk factors for CRCI is limited. While some research suggests a role for the ε4 allele, the literature is generally inconsistent, and the currently available evidence does not allow clear-cut conclusions regarding the role of genetic factors in the development of CRCI. Larger genetic studies and studies investigating additional genetic variants are needed to uncover genetic risk factors for CRCI.
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Affiliation(s)
- Cecilie D. R. Buskbjerg
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Ali Amidi
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Ditte Demontis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Department of Biomedicine – Human Genetics, Aarhus University, Aarhus, Denmark
| | - Eva R. Nissen
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Robert Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, and Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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29
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Tometich DB, Small BJ, Carroll JE, Zhai W, Luta G, Zhou X, Kobayashi LC, Ahles T, Saykin AJ, Clapp JD, Jim HSL, Jacobsen PB, Hurria A, Graham D, McDonald BC, Denduluri N, Extermann M, Isaacs C, Dilawari A, Root J, Rini C, Mandelblatt JS. Pretreatment Psychoneurological Symptoms and Their Association With Longitudinal Cognitive Function and Quality of Life in Older Breast Cancer Survivors. J Pain Symptom Manage 2019; 57:596-606. [PMID: 30472317 PMCID: PMC6382533 DOI: 10.1016/j.jpainsymman.2018.11.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 12/22/2022]
Abstract
CONTEXT Symptoms affect quality of life (QOL), functional status, and cognitive function in cancer survivors, but older survivors are understudied. OBJECTIVES The objectives of this study were to identify prototypical presystemic therapy psychoneurological symptom clusters among older breast cancer survivors and determine whether these symptom clusters predicted cognition and QOL over time. METHODS Women with newly diagnosed nonmetastatic breast cancer (n = 319) and matched noncancer controls (n = 347) aged 60+ years completed questionnaires and neuropsychological tests before systemic therapy and 12 and 24 months later. Latent class analysis identified clusters of survivors based on their pretherapy depression, anxiety, fatigue, sleep disturbance, and pain. Linear mixed-effects models examined changes in objective cognition, perceived cognition, and functional status (Instrumental Activities of Daily Living disability, functional well-being, and breast cancer-specific QOL) by group, controlling for covariates. RESULTS Nearly one-fifth of older survivors were classified as having high pretherapy symptoms (n = 51; 16%); the remainder had low symptoms (n = 268; 84%); both groups improved over time on all outcomes. However, compared to the low symptom group and controls, survivors with high symptoms had lower baseline objective cognition and lower perceived cognition at baseline and 24 months, lower functional well-being at baseline and 12 months, greater Instrumental Activities of Daily Living disability at baseline, and lower breast cancer-specific QOL at all time points (all P < 0.05). CONCLUSION Nearly one-fifth of older breast cancer survivors had high psychoneurological symptoms at diagnosis, which predicted clinically meaningful decrements in perceived cognition and function in the first 24 months after diagnosis. Pretreatment psychoneurological symptom clusters could identify survivors for monitoring or intervention.
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Affiliation(s)
- Danielle B Tometich
- Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA.
| | - Brent J Small
- Moffitt Cancer Center, Tampa, Florida, USA; University of South Florida, Tampa, Florida, USA
| | - Judith E Carroll
- University of California Los Angeles and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Wanting Zhai
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - George Luta
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Xingtao Zhou
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Lindsay C Kobayashi
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Tim Ahles
- Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Andrew J Saykin
- Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| | - Jonathan D Clapp
- University of South Florida, Tampa, Florida, USA; Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | | | | | - Arti Hurria
- City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Brenna C McDonald
- Indiana University School of Medicine and Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana, USA
| | | | | | - Claudine Isaacs
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - Asma Dilawari
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
| | - James Root
- Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Christine Rini
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA; John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Jeanne S Mandelblatt
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, District of Columbia, USA
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Tan CJ, Lim SWT, Toh YL, Ng T, Yeo A, Shwe M, Foo KM, Chu P, Jain A, Koo SL, Dent RA, Ng RCH, Yap YS, Lim EH, Loh KWJ, Chay WY, Lee GE, Tan TJY, Beh SY, Wong M, Chan JJ, Khor CC, Ho HK, Chan A. Replication and Meta-analysis of the Association between BDNF Val66Met Polymorphism and Cognitive Impairment in Patients Receiving Chemotherapy. Mol Neurobiol 2018; 56:4741-4750. [PMID: 30382534 PMCID: PMC6647505 DOI: 10.1007/s12035-018-1410-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/24/2018] [Indexed: 01/23/2023]
Abstract
Cancer-related cognitive impairment (CRCI) adversely affects cancer patients. We had previously demonstrated that the BDNF Val66Met genetic polymorphism is associated with lower odds of subjective CRCI in the multitasking and verbal ability domains among breast cancer patients receiving chemotherapy. To further assess our previous findings, we evaluated the association of BDNF Val66Met polymorphism with subjective and objective CRCI in a temporally separate cohort of patients and pooled findings from both the original (n = 145) and current (n = 193) cohorts in a meta-analysis. Subjective CRCI was assessed using FACT-Cog. Objective CRCI was evaluated using computerized neuropsychological tests. Genotyping was carried out using Sanger sequencing. The association of BDNF Val66Met genotypes and CRCI was examined with logistic regression. A fixed-effect meta-analysis was conducted using the inverse variance method. In the meta-analysis (n = 338), significantly lower odds of CRCI were associated with Met allele carriers based on the global FACT-Cog score (OR = 0.52, 95% CI 0.29–0.94). Furthermore, Met allele carriers were at lower odds of developing impairment in the domains of memory (OR = 0.34, 95% CI: 0.17–0.70), multitasking (OR = 0.33, 95% CI: 0.18–0.59), and verbal ability (OR = 0.46, 95% CI: 0.24–0.88). Consistent with the previous study, lower odds of subjective CRCI among patients with the BDNF Met allele was observed after adjusting for potential confounders in the multitasking (OR = 0.30, 95% CI: 0.14–0.67) domain. In conclusion, carriers of the BDNF Met allele were protected against global subjective CRCI, particularly in the domains of memory, multitasking, and verbal ability. Our findings further contribute to the understanding of CRCI pathophysiology.
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Affiliation(s)
- Chia Jie Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Sheree Wan Ting Lim
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Yi Long Toh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Terence Ng
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Angie Yeo
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Maung Shwe
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Koon Mian Foo
- Department of Pharmacy, K.K. Women's and Children's Hospital, Singapore, Singapore
| | - Pat Chu
- Singapore Cord Blood Bank, Singapore, Singapore
| | - Amit Jain
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Si-Lin Koo
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Rebecca A Dent
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | | | - Yoon Sim Yap
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Elaine H Lim
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Kiley Wei-Jen Loh
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Wen Yee Chay
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Guek Eng Lee
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Tira Jing Ying Tan
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Sok Yuen Beh
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Mabel Wong
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Jack Junjie Chan
- Division of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Chiea Chuen Khor
- Human Genetics, Genome Institute of Singapore, Singapore, Singapore.,Glaucoma Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Han Kiat Ho
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore
| | - Alexandre Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4, 18 Science Drive 4, Singapore, 117543, Singapore. .,Department of Pharmacy, National Cancer Centre, Singapore, Singapore. .,Duke-NUS Graduate Medical School, Singapore, Singapore.
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Yang GS, Kumar S, Dorsey SG, Starkweather AR, Kelly DL, Lyon DE. Systematic review of genetic polymorphisms associated with psychoneurological symptoms in breast cancer survivors. Support Care Cancer 2018; 27:351-371. [PMID: 30343412 DOI: 10.1007/s00520-018-4508-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/09/2018] [Indexed: 01/10/2023]
Abstract
PURPOSE Psychoneurological (PN) symptoms, such as anxiety, cognitive impairment, depression, fatigue, sleep disturbances, and pain, are highly prevalent in breast cancer patients undergoing cancer treatment. Emerging evidence suggests that genetic polymorphisms may contribute to differential symptom susceptibility. We aimed to systematically review associations between genetic polymorphisms and PN symptoms during or after cancer treatment for early-stage breast cancer. METHODS Twenty-six eligible articles published until October 2017 were identified in PubMed, PsycINFO, Web of Science, and additional records. Information on study characteristics, genetic polymorphisms, and PN symptoms was extracted. Study quality was evaluated by the STrengthening the REporting of Genetic Association (STREGA) guideline. Genes included in the analysis were categorized by biological pathways based on the Reactome database. RESULTS A total of 54 single nucleotide polymorphisms and haplotypes that are significantly associated with PN symptoms were identified; half of them were associated with increased severity of PN symptoms, while the other half contributed to the decrease of PN symptoms. Pain has the known highest number of associated genetic polymorphisms reported, followed by fatigue, cognitive impairment, depressive symptoms, sleep disturbances, and anxiety. The majority of genetic polymorphisms were involved in immune system and neuronal system pathways. Most studies were unsuccessful in meeting the STREGA guideline, which requires transparent reporting of methods and results. CONCLUSIONS This review provides comprehensive evidence of genetic polymorphisms underlying PN symptoms, which may pave the way for the development of personalized therapeutics targeting these symptoms. More well-designed genome-wide association studies are required to validate and replicate these findings.
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Affiliation(s)
- Gee Su Yang
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA.
| | - Sreelakshmy Kumar
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA
| | - Susan G Dorsey
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA
| | | | - Debra Lynch Kelly
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA
| | - Debra E Lyon
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA
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Merriman JD, Sereika SM, Conley YP, Koleck TA, Zhu Y, Phillips ML, Bertocci MA, Brufsky AM, Bender CM. Exploratory Study of Associations Between DNA Repair and Oxidative Stress Gene Polymorphisms and Cognitive Problems Reported by Postmenopausal Women With and Without Breast Cancer. Biol Res Nurs 2018; 21:50-60. [PMID: 30213196 DOI: 10.1177/1099800418799964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Women with breast cancer report varying frequencies of cognitive problems during adjuvant systemic therapy. This variability suggests latent subgroups. Therefore, we identified latent subgroups of self-reported cognitive problems among postmenopausal women with and without breast cancer. We explored associations between membership in these subgroups and (a) demographic, clinical, and symptom characteristics and (b) variations in candidate gene polymorphisms. METHODS We evaluated frequency of cognitive problems using the Patient Assessment of Own Functioning Inventory. Growth mixture modeling identified latent subgroups over 18 months of adjuvant systemic therapy and at matched time points for women without cancer ( N = 331). We evaluated for differences among subgroups in demographic, clinical, and symptom characteristics and in 41 single nucleotide polymorphisms in 10 candidate genes involved in DNA repair and oxidative stress pathways ( n = 199). We modeled associations between genotypes and subgroup membership using multinomial logistic regression. RESULTS We identified three latent subgroups: more frequent, persistent, and almost never. Receipt of chemotherapy plus anastrozole, depressive symptoms, and baseline neuropathic symptoms increased the odds of belonging to the more frequent subgroup. Anxiety and depressive symptoms increased the odds of belonging to the persistent subgroup. With covariates controlled for, carrying the ERCC5 rs873601 G minor allele increased the odds of reporting more frequent cognitive problems. CONCLUSIONS Chemotherapy plus anastrozole, depressive symptoms, and presence of neuropathic symptoms may predict more frequent cognitive problems during systemic therapy that later resolve. Mood dysregulation before therapy may predict persistent cognitive problems during therapy. ERCC5 genotype may influence frequency of cognitive problems after controlling for these risk factors.
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Affiliation(s)
- John D Merriman
- 1 New York University Meyers College of Nursing, New York, NY, USA
| | - Susan M Sereika
- 2 School of Nursing, University of Pittsburgh, Pittsburgh, USA.,3 Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yvette P Conley
- 2 School of Nursing, University of Pittsburgh, Pittsburgh, USA.,3 Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Yehui Zhu
- 2 School of Nursing, University of Pittsburgh, Pittsburgh, USA
| | - Mary L Phillips
- 5 School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Adam M Brufsky
- 5 School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,6 University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Catherine M Bender
- 2 School of Nursing, University of Pittsburgh, Pittsburgh, USA.,6 University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
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Abstract
As the population of cancer survivors has grown into the millions, there has been increasing emphasis on understanding how the late effects of treatment affect survivors' ability to return to work/school, their capacity to function and live independently, and their overall quality of life. This review focuses on cognitive change associated with cancer and cancer treatments. Research in this area has progressed from a pharmacotoxicology perspective to a view of the cognitive change as a complex interaction of aspects of the treatment, vulnerability factors that increase risk for posttreatment cognitive decline, cancer biology, and the biology of aging. Methodological advances include the development of (a) measurement approaches that assess more fine-grained subcomponents of cognition based on cognitive neuroscience and (b) advanced statistical approaches. Conceptual issues that arise from this multidimensional perspective are described in relation to future directions, understanding of mechanisms, and development of innovative interventions.
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Affiliation(s)
- Tim A Ahles
- Neurocognitive Research Lab, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA; ,
| | - James C Root
- Neurocognitive Research Lab, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA; ,
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Cognitive impairment in breast cancer survivors treated with chemotherapy depends on control group type and cognitive domains assessed: A multilevel meta-analysis. Neurosci Biobehav Rev 2017; 83:417-428. [DOI: 10.1016/j.neubiorev.2017.10.028] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/01/2017] [Accepted: 10/27/2017] [Indexed: 01/21/2023]
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Matsos A, Loomes M, Zhou I, Macmillan E, Sabel I, Rotziokos E, Beckwith W, Johnston I. Chemotherapy-induced cognitive impairments: White matter pathologies. Cancer Treat Rev 2017; 61:6-14. [DOI: 10.1016/j.ctrv.2017.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 09/27/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
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Kesler SR, Rao V, Ray WJ, Rao A. Probability of Alzheimer's disease in breast cancer survivors based on gray-matter structural network efficiency. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 9:67-75. [PMID: 29201992 PMCID: PMC5700833 DOI: 10.1016/j.dadm.2017.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction Breast cancer chemotherapy is associated with accelerated aging and potentially increased risk for Alzheimer's disease (AD). Methods We calculated the probability of AD diagnosis from brain network and demographic and genetic data obtained from 47 female AD converters and 47 matched healthy controls. We then applied this algorithm to data from 78 breast cancer survivors. Results The classifier discriminated between AD and healthy controls with 86% accuracy (P < .0001). Chemotherapy-treated breast cancer survivors demonstrated significantly higher probability of AD compared to healthy controls (P < .0001) and chemotherapy-naïve survivors (P = .007), even after stratifying for apolipoprotein e4 genotype. Chemotherapy-naïve survivors also showed higher AD probability compared to healthy controls (P = .014). Discussion Chemotherapy-treated breast cancer survivors who have a particular profile of brain structure may have a higher risk for AD, especially those who are older and have lower cognitive reserve.
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Affiliation(s)
- Shelli R. Kesler
- Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Corresponding author. Tel.: +713-792-8296; Fax: +713-794-4999.
| | - Vikram Rao
- Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William J. Ray
- The Neurodegeneration Consortium at the Institute of Applied Cancer Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Arvind Rao
- Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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37
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Cognitive impairment and chemotherapy: a brief overview. Crit Rev Oncol Hematol 2017; 118:7-14. [DOI: 10.1016/j.critrevonc.2017.08.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 08/01/2017] [Accepted: 08/09/2017] [Indexed: 02/01/2023] Open
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38
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McGinnis GJ, Raber J. CNS side effects of immune checkpoint inhibitors: preclinical models, genetics and multimodality therapy. Immunotherapy 2017; 9:929-941. [PMID: 29338610 PMCID: PMC6161123 DOI: 10.2217/imt-2017-0056] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/09/2017] [Indexed: 02/06/2023] Open
Abstract
Following cancer treatment, patients often report behavioral and cognitive changes. Novel cancer immunotherapeutics have the potential to produce sustained cancer survivorship, meaning patients will live longer with the side effects of treatment. Given the role of inflammatory pathways in mediating behavioral and cognitive impairments seen in cancer, we aim in this review to discuss emerging evidence for the contribution of immune checkpoint blockade to exacerbate these CNS effects. We discuss ongoing studies regarding the ability of immune checkpoint inhibitors to reach the brain and how treatment responses to checkpoint inhibitors may be modulated by genetic factors. We further consider the use of preclinical tumor-models to study the role of tumor status in CNS effects of immune checkpoint inhibitors and multimodality therapy.
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Affiliation(s)
- Gwendolyn J McGinnis
- Department of Radiation Medicine, Oregon Health & Science University, OR, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, OR, USA
| | - Jacob Raber
- Department of Radiation Medicine, Oregon Health & Science University, OR, USA
- Department of Behavioral Neuroscience, Oregon Health & Science University, OR, USA
- Department of Neurology, Oregon Health & Science University, OR, USA
- Division of Neuroscience, Oregon National Primate Research Center, 505 NW 185th Ave, Beaverton, OR 97006, USA
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Koleck TA, Bender CM, Clark BZ, Ryan CM, Ghotkar P, Brufsky A, McAuliffe PF, Rastogi P, Sereika SM, Conley YP. An exploratory study of host polymorphisms in genes that clinically characterize breast cancer tumors and pretreatment cognitive performance in breast cancer survivors. BREAST CANCER (DOVE MEDICAL PRESS) 2017; 9:95-110. [PMID: 28424560 PMCID: PMC5344452 DOI: 10.2147/bctt.s123785] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE Inspired by the hypothesis that heterogeneity in the biology of breast cancers at the cellular level may account for cognitive dysfunction symptom variability in survivors, the current study explored relationships between host single-nucleotide polymorphisms (SNPs) in 25 breast cancer-related candidate genes (AURKA, BAG1, BCL2, BIRC5, CCNB1, CD68, CENPA, CMC2, CTSL2, DIAPH3, ERBB2, ESR1, GRB7, GSTM1, MELK, MKI67, MMP11, MYBL2, NDC80, ORC6, PGR, RACGAP1, RFC4, RRM2, and SCUBE2), identified from clinically relevant prognostic multigene-expression profiles for breast cancer, and pretreatment cognitive performance. PATIENTS AND METHODS The sample (n=220) was comprised of 138 postmenopausal women newly diagnosed with early stage breast cancer and 82 postmenopausal age- and education-matched healthy controls without breast cancer. Cognitive performance was assessed after primary surgery but prior to initiation of adjuvant chemotherapy and/or hormonal therapy using a comprehensive battery of neuropsychological tests encompassing eight cognitive function composite domains: attention, concentration, executive function, mental flexibility, psychomotor speed, verbal memory, visual memory, and visual working memory. In total, 131 SNPs were included in the analysis. Standard and robust multiple linear regression modeling was used to examine relationships between each domain and the presence or absence of one or more minor alleles for each SNP. Genetic risk/protection scores (GRSs) were calculated for each domain to evaluate the collective effect of possession of multiple risk/protective alleles. RESULTS With the exception of CMC2, MMP11, and RACGAP1, significant (P<0.05) SNP main effect and/or SNP by future prescribed treatment group interactions were observed for every gene between at least one domain and one or more SNPs. All GRSs were found to be significantly (P<0.001) associated with each respective domain score. CONCLUSION Associations between host SNPs and computed GRSs and variability in pretreatment cognitive function performance support the study hypothesis, and warrant further investigations to identify biomarkers for breast cancer-related cognitive dysfunction.
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Affiliation(s)
- Theresa A Koleck
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
- School of Nursing, Columbia University, New York, NY
| | | | - Beth Z Clark
- Division of Gynecologic Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center (UPMC)
- School of Medicine
| | - Christopher M Ryan
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA
| | - Puja Ghotkar
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
| | - Adam Brufsky
- School of Medicine
- Division of Hematology/Oncology, Magee-Womens Hospital of UPMC
- University of Pittsburgh Cancer Institute
| | - Priscilla F McAuliffe
- School of Medicine
- University of Pittsburgh Cancer Institute
- Division of Breast Surgical Oncology, Magee-Womens Hospital of UPMC
| | - Priya Rastogi
- School of Medicine
- Division of Hematology/Oncology, Magee-Womens Hospital of UPMC
| | - Susan M Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
- Department of Biostatistics
- Department of Epidemiology
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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40
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Cheng H, Li W, Gan C, Zhang B, Jia Q, Wang K. The COMT (rs165599) gene polymorphism contributes to chemotherapy-induced cognitive impairment in breast cancer patients. Am J Transl Res 2016; 8:5087-5097. [PMID: 27904710 PMCID: PMC5126352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/04/2016] [Indexed: 06/06/2023]
Abstract
The present study aimed to investigate the effect of genetic polymorphisms of catechol-O-methyl transferase (COMT), apolipoprotein E (APOE), and brain derived neurotrophic factor (BDNF) on the modulation of the chemotherapy-induced cognitive impairment (CICI) in breast cancer patients. Eighty triple negative breast cancer (TNBC) and 165 non-triple negative breast cancer (NTNBC) patients were selected, and subjected to a number of neuropsychological tests, including memory questionnaires, before and after chemotherapy. Six single-nucleotide polymorphisms (SNPs), including COMT (rs165599, rs4680, rs737865), APOE (rs429358, rs7412), and BDNF (rs6265), were evaluated. The scores of breast cancer patients after chemotherapy were poorer in comparison to those before chemotherapy (t = -5.317, z = -3.372, respectively, P < 0.01), and the scores of TNBC patients were poorer than those of NTNBC patients were after chemotherapy (t = -5.997, z = -5.284, respectively, P < 0.01). Patients with the COMT (rs165599) genotype had a significantly lower chance of developing cognitive decline than the patients with the G/G genotype, and this was linear with the retrospective memory (RM) questionnaires (β = -1.441, CI (95%) = -2.781~-0.101). However, there was no significant difference between the memory scores of APOE (rs429358, rs7412) and BDNF (rs6265) carriers before or after chemotherapy. This study suggests that CICI in TNBC patients was more prominent than that in NTNBC patients after chemotherapy, and the COMT (rs165599) polymorphism was linear to the retrospective memory (RM) questionnaires, and may be a potential genetic marker for increased vulnerability to CICI in TNBC patients.
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Affiliation(s)
- Huaidong Cheng
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Wen Li
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Chen Gan
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Bo Zhang
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Qianqian Jia
- Department of Oncology, The Second Affiliated Hospital of Anhui Medical UniversityHefei 230601, Anhui, China
| | - Kai Wang
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Neuropsychological Laboratory, Department of Neurology, The First Affiliated Hospital of Anhui Medical UniversityHefei 230022, Anhui, China
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Menning S, de Ruiter MB, Kieffer JM, Agelink van Rentergem J, Veltman DJ, Fruijtier A, Oldenburg HSA, Boven E, van der Meij S, Lustig V, Bos MEM, Boogerd W, Reneman L, Schagen SB. Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study. J Pain Symptom Manage 2016; 52:560-569.e1. [PMID: 27650011 DOI: 10.1016/j.jpainsymman.2016.04.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/12/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
Abstract
CONTEXT Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function. OBJECTIVES To investigate the effects of systemic treatment on cognitive performance in BC patients. METHODS Participants were BC patients scheduled to receive systemic treatment (BC + SYST; n = 31), or no systemic treatment (BC; n = 24) and no-cancer (NC) controls (n = 33). Neuropsychological examinations were used to study cognitive performance on 18 tests grouped into eight cognitive domains, before adjuvant treatment (T1) and six months after chemotherapy (T2), or at similar intervals. We also assessed health-related quality of life, anxiety and depression, mood, stress, and cognitive problems. Analysis of variance was used to assess group differences of cognitive performance and multivariate normative comparison to classify impairment, comparing scores of each participant against the distribution of the scores of NC controls. RESULTS Of BC + SYST, 16% were cognitively impaired at T2, compared to 4% in BC and 6% in NC. Although not significant, we observed moderate effect sizes for worse performance in the BC + SYST group compared to NC (Flanker congruent [effect size {ES} = 0.44] and stimulus incongruent [ES = 0.44]) and compared to BC (Controlled Oral Word Association Test [ES = 0.47], digit span [ES = 0.41], and Hopkins Verbal Learning Test immediate [ES = 0.71] and delayed recall [ES = 0.65]). Cognitively impaired patients had a significantly lower estimated premorbid intelligence, worse physical and social functioning, and more distress at T2 compared to unimpaired patients. CONCLUSION Our findings indicate that cognitive impairment after systemic treatment occurs in a subset of BC patients. The predictive value of demographic and psychosocial factors in cognitive impairment should be further investigated in a larger sample of impaired patients.
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Affiliation(s)
- Sanne Menning
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel B de Ruiter
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jacobien M Kieffer
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Agnetha Fruijtier
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hester S A Oldenburg
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Epie Boven
- Department of Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands
| | - Suzan van der Meij
- Department of Surgery, Flevo Hospital, Almere, The Netherlands; Breast Cancer Department, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Vera Lustig
- Department of Medical Oncology, Flevo Hospital, Almere, The Netherlands
| | - Monique E M Bos
- Department of Internal Medicine, Reinier de Graaf Hospital, Delft, The Netherlands
| | - Willem Boogerd
- Department of Neuro-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Liesbeth Reneman
- Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
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Wefel JS, Noll KR, Scheurer ME. Neurocognitive functioning and genetic variation in patients with primary brain tumours. Lancet Oncol 2016; 17:e97-e108. [PMID: 26972863 PMCID: PMC5215729 DOI: 10.1016/s1470-2045(15)00380-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/10/2015] [Accepted: 09/28/2015] [Indexed: 01/09/2023]
Abstract
Impairment of neurocognitive functioning is a common result of cerebral neoplasms and treatment, although there is substantial heterogeneity in the pattern and severity of neurocognitive dysfunction across individuals and tumour types. The effects of many clinical and patient characteristics on neurocognitive functioning have been documented, but little research has been devoted to understanding the effect of genetic variation on neurocognitive outcomes in patients with brain tumours. This Review highlights preliminary evidence that suggests an association between various genes and risk of adverse neurocognitive outcomes in patients with brain tumours. Studies include genes specific to neuronal function, and those associated with more systemic cellular regulation. Related scientific literature in other disease populations is briefly discussed to indicate additional candidate genes. We consider methodological issues central to the study of neurocognitive functioning and genetic associations for patients with brain tumours, and emphasise the need for future research integrating novel investigative techniques.
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Affiliation(s)
- Jeffrey S Wefel
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Kyle R Noll
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA
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Jean-Pierre P, McDonald B. Neuroepidemiology of cancer and treatment-related neurocognitive dysfunction in adult-onset cancer patients and survivors. Neuroepidemiology 2016; 138:297-309. [DOI: 10.1016/b978-0-12-802973-2.00017-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Vardy JL, Dhillon HM, Pond GR, Rourke SB, Bekele T, Renton C, Dodd A, Zhang H, Beale P, Clarke S, Tannock IF. Cognitive Function in Patients With Colorectal Cancer Who Do and Do Not Receive Chemotherapy: A Prospective, Longitudinal, Controlled Study. J Clin Oncol 2015; 33:4085-92. [PMID: 26527785 DOI: 10.1200/jco.2015.63.0905] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Cognitive dysfunction is reported in people with cancer. Therefore, we evaluated longitudinal changes in cognitive function and underlying mechanisms in people with colorectal cancer (CRC) and healthy controls (HCs). PATIENTS AND METHODS Participants completed cognitive assessments and questionnaires reporting cognitive symptoms, fatigue, quality of life, and anxiety/depression at baseline (before chemotherapy, if given) and 6, 12, and 24 months. Blood tests included cytokines, clotting factors, apolipoprotein E genotype, and sex hormones. Primary end point was overall cognitive function measured by the Global Deficit Score at 12 months. RESULTS We recruited 289 patients with localized CRC (173 received chemotherapy; median age, 59 years; 63% male), 73 patients with limited metastatic/recurrent CRC, and 72 HCs. Cognitive impairment was more frequent in patients with localized CRC than HCs at baseline (43% v 15%, respectively; P < .001) and 12 months (46% v 13%, respectively; P < .001), with no significant effect of chemotherapy. Attention/working memory, verbal learning/memory, and complex processing speed were most affected. Cognitive impairment was similar in patients with localized and metastatic CRC. Cytokine levels were elevated in patients with CRC compared with HCs. There was no association between overall cognitive function and fatigue, quality of life, anxiety/depression, or any blood test. Cognitive symptoms at 12 months were reported in 25% of patients with localized CRC versus 17% of HCs (P = .19). More participants who received chemotherapy had cognitive symptoms at 6 months (32%) versus those who did not (16%; P = .007), with no significant difference at 12 months (29% v 21%, respectively; P = .19). Objective cognitive function was only weakly associated with cognitive symptoms. CONCLUSION Patients with CRC had substantially more cognitive impairment at every assessment than HCs, with no significant added effect of chemotherapy. Mechanisms of cognitive impairment remain unknown.
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Affiliation(s)
- Janette L Vardy
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada.
| | - Haryana M Dhillon
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Gregory R Pond
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Sean B Rourke
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Tsegaye Bekele
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Corrinne Renton
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Anna Dodd
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Haibo Zhang
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Philip Beale
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Clarke
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
| | - Ian F Tannock
- Janette L. Vardy, Haryana M. Dhillon, Corrinne Renton, and Stephen Clarke, University of Sydney; Janette L. Vardy and Philip Beale, Concord Cancer Centre, Sydney, New South Wales, Australia; Janette L. Vardy, Anna Dodd, and Ian F. Tannock, Princess Margaret Cancer Centre, University of Toronto; Sean B. Rourke, Tsegaye Bekele, and Haibo Zhang, St Michael's Hospital, University of Toronto, Toronto; and Gregory R. Pond, McMaster University, Hamilton, Ontario, Canada
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Gonzalez BD, Jim HSL, Booth-Jones M, Small BJ, Sutton SK, Lin HY, Park JY, Spiess PE, Fishman MN, Jacobsen PB. Course and Predictors of Cognitive Function in Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Controlled Comparison. J Clin Oncol 2015; 33:2021-7. [PMID: 25964245 PMCID: PMC4461804 DOI: 10.1200/jco.2014.60.1963] [Citation(s) in RCA: 149] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Men receiving androgen-deprivation therapy (ADT) for prostate cancer may be at risk for cognitive impairment; however, evidence is mixed in the existing literature. Our study examined the impact of ADT on impaired cognitive performance and explored potential demographic and genetic predictors of impaired performance. PATIENTS AND METHODS Patients with prostate cancer were assessed before or within 21 days of starting ADT (n = 58) and 6 and 12 months later. Age- and education-matched patients with prostate cancer treated with prostatectomy only (n = 84) and men without prostate cancer (n = 88) were assessed at similar intervals. Participants provided baseline blood samples for genotyping. Mean-level cognitive performance was compared using mixed models; cognitive impairment was compared using generalized estimating equations. RESULTS ADT recipients demonstrated higher rates of impaired cognitive performance over time relative to all controls (P = .01). Groups did not differ at baseline (P > .05); however, ADT recipients were more likely to demonstrate impaired performance within 6 and 12 months (P for both comparisons < .05). Baseline age, cognitive reserve, depressive symptoms, fatigue, and hot flash interference did not moderate the impact of ADT on impaired cognitive performance (P for all comparisons ≥ .09). In exploratory genetic analyses, GNB3 single-nucleotide polymorphism rs1047776 was associated with increased rates of impaired performance over time in the ADT group (P < .001). CONCLUSION Men treated with ADT were more likely to demonstrate impaired cognitive performance within 6 months after starting ADT relative to matched controls and to continue to do so within 12 months after starting ADT. If confirmed, findings may have implications for patient education regarding the risks and benefits of ADT.
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Affiliation(s)
- Brian D Gonzalez
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL.
| | - Heather S L Jim
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Margaret Booth-Jones
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Brent J Small
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Steven K Sutton
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Hui-Yi Lin
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Jong Y Park
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Philippe E Spiess
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Mayer N Fishman
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
| | - Paul B Jacobsen
- Brian D. Gonzalez, Heather S.L. Jim, Margaret Booth-Jones, Steven K. Sutton, Hui-Yi Lin, Jong Y. Park, Philippe E. Spiess, Mayer N. Fishman, and Paul B. Jacobsen, Moffitt Cancer Center; and Brent J. Small, University of South Florida, Tampa, FL
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