Cognitive impairment (chemobrain) in early breast cancer patients treated with anthracycline/taxane chemotherapy.
Kenny, L Vicidomini, R Wardeh, SA Riddle, P Pettit, L Gayani, P Staples, E McLeavy, L Kanwar, J Edison, P
Kenny, L
Vicidomini, R
Wardeh, SA
Riddle, P
Pettit, L
Gayani, P
Staples, E
McLeavy, L
Kanwar, J
Edison, P
Affiliation
Imperial College Healthcare NHS Trust; West Middlesex University Hospital; Royal Shrewsbury Hospital; The Dudley Group NHS Foundation Trust
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Publication date
2025/05/01
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Abstract
Chemotherapy-induced cognitive impairment (CICI) occurs in ~33% of post-chemotherapy breast cancer patients, and is associated with transient or enduring cognitive deficits. However, the aetiology and underlying pathophysiology is yet to be determined. 270 early breast cancer patients who received anthracycline (AC/EC) and/or taxane chemotherapy within the previous 12 months were enrolled from UK sites. Clinical and neurocognitive tests were performed on an Artificial Intelligence platform. 18 patients with low cognitive scores, along with 19 controls, underwent further in-person neurocognitive assessments and brain MRI(3T) in Imperial College London. MRI images were analysed using Region of Interest (ROI) and Voxel-Based Morphometric (VBM) analysis. The mean age of the patients was 55.6 years (controls=66.7) and average time between initiation of chemotherapy and MRI was 14.1 months. 13/18 received AC/EC-taxanes, 2 received TC, and 3 received taxanes. At the time of MRI, most patients had completed cytotoxic therapy, and 89% were undergoing endocrine therapy. ROI and VBM analyses of CICI patients consistently demonstrated significantly lower grey matter volumes (mm3) and surface areas (mm2) in the following regions: cingulate cortex, medial and orbitofrontal regions of the frontal lobe, precuneus and parietal areas, temporal pole, and lingual cortex. This was associated with poorer semantic, verbal fluency and lower MMSE scores in CICI patients. This preliminary data reveals significant cerebral morphological changes and cognitive impairment following anthracycline-taxane chemotherapy. This highlights an urgent need to investigate CICI in a larger cohort of patients to evaluate whether chemotherapy could induce neurodegenerative process so that long-term preventative strategies could be developed. 1) BMJ Ref: Fleming et al. "Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management" BMJ.2023Mar15;380:e071726. Legal entity responsible for the study: Imperial College London. Imperial NIHR Biomedical Research Centre UK. Disclosure:
Citation
L. Kenny, R. Vicidomini, S. Abu Wardeh, P. Riddle, L. Pettit, P. Gayani, E. Staples, L. McLeavy, J. Kanwar, P. Edison, 426P Cognitive impairment (chemobrain) in early breast cancer patients treated with anthracycline/taxane chemotherapy, ESMO Open, Volume 10, Supplement 4, 2025, 104998, ISSN 2059-7029, https://doi.org/10.1016/j.esmoop.2025.104998.