Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study
Abstract Background There is little information about cancer‐related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15–39 years old) due to its rare incidence. Here, we present the pre‐treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of A...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5295 |
| _version_ | 1828002828977700864 |
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| author | Alexandre Chan Ivy Cheng Claire Wang Chia Jie Tan Yi Long Toh Ding Quan Ng Yong Qin Koh Hanzhang Zhou Koon Mian Foo Raymond Javan Chan Han Kiat Ho Lita Chew Mohamad Farid Ian Tannock |
| author_facet | Alexandre Chan Ivy Cheng Claire Wang Chia Jie Tan Yi Long Toh Ding Quan Ng Yong Qin Koh Hanzhang Zhou Koon Mian Foo Raymond Javan Chan Han Kiat Ho Lita Chew Mohamad Farid Ian Tannock |
| author_sort | Alexandre Chan |
| collection | DOAJ |
| description | Abstract Background There is little information about cancer‐related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15–39 years old) due to its rare incidence. Here, we present the pre‐treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of AYA with cancer (AYAC) in a multicentered cohort study. Methods Newly diagnosed AYAC and age‐matched healthy controls (HC) were recruited between 2018 and 2021. The primary outcome was the comparison of pre‐treatment cognitive impairment defined as 2 standard deviations (SDs) below the HC on ≥1 cognitive test, or >1.5 SDs below on ≥2 tests using CANTAB® between AYAC and HC. Secondary outcomes included self‐perceived cognitive ability assessed by FACT‐Cog v3 and biomarkers (inflammatory cytokines and brain‐derived neurotrophic factor [BDNF]). Results We recruited 74 AYAC (median age = 34) and 118 HC (median age = 32). On objective cognitive testing, we observed three times more AYAC patients performed poorly on at least 2 cognitive tests compared to HC (40.5% vs. 13.6%, p < 0.001). AYAC self‐perceived less degree of cognitive impairment than HC (p < 0.001). However, AYAC perceived a greater impact of cognitive changes on their quality of life compared to HC (p = 0.039). Elevated baseline inflammatory markers (IL‐2, IL‐4, IL‐6, IL‐8, IL‐10 and IFN‐γ) were observed among AYAC compared to HC, and baseline BDNF was lower in AYAC compared to HC. Interaction effects between cancer diagnosis and biomarkers were observed in predicting cognitive function. Conclusion With the pre‐existence of CRCI and risk factors of neuroinflammation even prior to systemic therapy, AYAC should receive early rehabilitation to prevent further deterioration of cognitive function after initiation of systemic therapies. (ClinicalTrials.gov Identifier: NCT03476070). |
| first_indexed | 2024-04-10T06:49:51Z |
| format | Article |
| id | doaj.art-c1d406691b044e288bf975b823f30c15 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T06:49:51Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-c1d406691b044e288bf975b823f30c152023-02-28T08:51:57ZengWileyCancer Medicine2045-76342023-02-011244821483110.1002/cam4.5295Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal studyAlexandre Chan0Ivy Cheng1Claire Wang2Chia Jie Tan3Yi Long Toh4Ding Quan Ng5Yong Qin Koh6Hanzhang Zhou7Koon Mian Foo8Raymond Javan Chan9Han Kiat Ho10Lita Chew11Mohamad Farid12Ian Tannock13Department of Clinical Pharmacy Practice University of California Irvine Irvine California USADepartment of Pharmacy National Cancer Centre Singapore SingaporeDepartment of Pharmacy National University of Singapore SingaporeDepartment of Pharmacy National University of Singapore SingaporeDepartment of Pharmacy National University of Singapore SingaporeDepartment of Clinical Pharmacy Practice University of California Irvine Irvine California USADepartment of Pharmacy National University of Singapore SingaporeDepartment of Pharmacy National University of Singapore SingaporeDepartment of Pharmacy KK Women and Children's Hospital SingaporeCaring Futures Institutes, College of Nursing and Health Sciences Flinders University Adelaide South Australia AustraliaDepartment of Pharmacy National University of Singapore SingaporeDepartment of Pharmacy National Cancer Centre Singapore SingaporeDivision of Medical Oncology National Cancer Centre Singapore SingaporePrincess Margaret Cancer Centre Toronto Ontario CanadaAbstract Background There is little information about cancer‐related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15–39 years old) due to its rare incidence. Here, we present the pre‐treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of AYA with cancer (AYAC) in a multicentered cohort study. Methods Newly diagnosed AYAC and age‐matched healthy controls (HC) were recruited between 2018 and 2021. The primary outcome was the comparison of pre‐treatment cognitive impairment defined as 2 standard deviations (SDs) below the HC on ≥1 cognitive test, or >1.5 SDs below on ≥2 tests using CANTAB® between AYAC and HC. Secondary outcomes included self‐perceived cognitive ability assessed by FACT‐Cog v3 and biomarkers (inflammatory cytokines and brain‐derived neurotrophic factor [BDNF]). Results We recruited 74 AYAC (median age = 34) and 118 HC (median age = 32). On objective cognitive testing, we observed three times more AYAC patients performed poorly on at least 2 cognitive tests compared to HC (40.5% vs. 13.6%, p < 0.001). AYAC self‐perceived less degree of cognitive impairment than HC (p < 0.001). However, AYAC perceived a greater impact of cognitive changes on their quality of life compared to HC (p = 0.039). Elevated baseline inflammatory markers (IL‐2, IL‐4, IL‐6, IL‐8, IL‐10 and IFN‐γ) were observed among AYAC compared to HC, and baseline BDNF was lower in AYAC compared to HC. Interaction effects between cancer diagnosis and biomarkers were observed in predicting cognitive function. Conclusion With the pre‐existence of CRCI and risk factors of neuroinflammation even prior to systemic therapy, AYAC should receive early rehabilitation to prevent further deterioration of cognitive function after initiation of systemic therapies. (ClinicalTrials.gov Identifier: NCT03476070).https://doi.org/10.1002/cam4.5295adolescent and young adultbrain‐derived neurotrophic factorcancercancer‐related cognitive impairmentcognitioninflammatory cytokines |
| spellingShingle | Alexandre Chan Ivy Cheng Claire Wang Chia Jie Tan Yi Long Toh Ding Quan Ng Yong Qin Koh Hanzhang Zhou Koon Mian Foo Raymond Javan Chan Han Kiat Ho Lita Chew Mohamad Farid Ian Tannock Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study Cancer Medicine adolescent and young adult brain‐derived neurotrophic factor cancer cancer‐related cognitive impairment cognition inflammatory cytokines |
| title | Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study |
| title_full | Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study |
| title_fullStr | Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study |
| title_full_unstemmed | Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study |
| title_short | Cognitive impairment in adolescent and young adult cancer patients: Pre‐treatment findings of a longitudinal study |
| title_sort | cognitive impairment in adolescent and young adult cancer patients pre treatment findings of a longitudinal study |
| topic | adolescent and young adult brain‐derived neurotrophic factor cancer cancer‐related cognitive impairment cognition inflammatory cytokines |
| url | https://doi.org/10.1002/cam4.5295 |
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