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Erschienen in: Breast Cancer Research and Treatment 2/2018

20.12.2017 | Review

Cognitive sequelae of endocrine therapy in women treated for breast cancer: a meta-analysis

verfasst von: E. A. Underwood, P. A. Rochon, R. Moineddin, P. E. Lee, W. Wu, K. I. Pritchard, M. C. Tierney

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 2/2018

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Abstract

Purpose

Evidence suggests anti-estrogen endocrine therapy (ET) is associated with adverse cognitive effects; however, findings are based on small samples and vary in the cognitive abilities affected. We conducted a meta-analysis to quantitatively synthesize the evidence.

Methods

Electronic databases were searched in November 2016. Fourteen studies totaling 911 BC patients on aromatase inhibitors (AIs) or tamoxifen (TAM) and 911 controls (i.e., non-cancer controls and BC controls not using ET) were included. Neuropsychological tests were categorized into six domains. Effect sizes were computed to compare (1) ET patients versus controls and (2) TAM patients versus AI patients.

Results

In cross-sectional comparisons, ET patients performed worse than control groups on verbal learning/memory, visual learning/memory, frontal executive function, and processing speed, but did not differ on psychomotor efficiency or visuospatial function. Subgroup analyses revealed that verbal learning/memory was the only domain where ET patients performed worse than both non-cancer and BC controls. In other domains, ET patients and BC controls performed equivalently. Regarding change from pre-treatment performance, ET patients did not differ from controls on any domain. TAM and AI patients did not from one another differ overall; however, subgroup analyses indicated that TAM patients performed better than non-steroidal AI patients on several domains, but showed few performance differences relative to steroidal AI patients.

Conclusions

Verbal learning/memory was the only domain where ET patients performed worse than both non-cancer and BC controls, suggesting specific adverse effects on this domain. Additional studies assessing change from pre-treatment performance and differences between steroidal and non-steroidal AIs are warranted.
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Literatur
1.
2.
Zurück zum Zitat Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, McGale P, Pan HC, Taylor C, Wang YC, Dowsett M, Ingle J, Peto R (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–784. https://doi.org/10.1016/s0140-6736(11)60993-8 CrossRefPubMed Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, McGale P, Pan HC, Taylor C, Wang YC, Dowsett M, Ingle J, Peto R (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–784. https://​doi.​org/​10.​1016/​s0140-6736(11)60993-8 CrossRefPubMed
12.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRefPubMed Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12(3):189–198CrossRefPubMed
13.
Zurück zum Zitat Wefel JS, Schagen SB (2012) Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep 12(3):267–275CrossRefPubMed Wefel JS, Schagen SB (2012) Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep 12(3):267–275CrossRefPubMed
16.
Zurück zum Zitat Stewart SA (2005) The effects of benzodiazepines on cognition. J Clin Psychiatr 66(Suppl 2):9–13 Stewart SA (2005) The effects of benzodiazepines on cognition. J Clin Psychiatr 66(Suppl 2):9–13
19.
Zurück zum Zitat Lezak MD (2004) Neuropsychological assessment. Oxford University Press, Oxford Lezak MD (2004) Neuropsychological assessment. Oxford University Press, Oxford
20.
Zurück zum Zitat Hedges LVO I (1985) Statistical methods for meta-analysis. Academic Press, San Diego Hedges LVO I (1985) Statistical methods for meta-analysis. Academic Press, San Diego
22.
Zurück zum Zitat Higgins J, Green S (2011) Identifying and measuring heterogeneity. Cochrane handbook for systematic reviews of interventions version 5.0, vol 1. The cochrane collaboration Higgins J, Green S (2011) Identifying and measuring heterogeneity. Cochrane handbook for systematic reviews of interventions version 5.0, vol 1. The cochrane collaboration
23.
Zurück zum Zitat Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Subgroup analyses. Introduction to meta-analysis. Wiley, Hoboken, pp 149–186CrossRef Borenstein M, Hedges LV, Higgins JPT, Rothstein HR (2009) Subgroup analyses. Introduction to meta-analysis. Wiley, Hoboken, pp 149–186CrossRef
25.
Zurück zum Zitat Schilder CM, Eggens PC, Seynaeve C, Linn SC, Boogerd W, Gundy CM, Beex LV, Van Dam FS, Schagen SB (2009) Neuropsychological functioning in postmenopausal breast cancer patients treated with tamoxifen or exemestane after ac-chemotherapy: cross-sectional findings from the neuropsychological team-side study. Acta Oncol 48(1):76–85. https://doi.org/10.1080/02841860802314738 CrossRefPubMed Schilder CM, Eggens PC, Seynaeve C, Linn SC, Boogerd W, Gundy CM, Beex LV, Van Dam FS, Schagen SB (2009) Neuropsychological functioning in postmenopausal breast cancer patients treated with tamoxifen or exemestane after ac-chemotherapy: cross-sectional findings from the neuropsychological team-side study. Acta Oncol 48(1):76–85. https://​doi.​org/​10.​1080/​0284186080231473​8 CrossRefPubMed
26.
Zurück zum Zitat Breckenridge LM, Bruns GL, Todd BL, Feuerstein M (2012) Cognitive limitations associated with tamoxifen and aromatase inhibitors in employed breast cancer survivors. Psycho-Oncol 21(1):43–53CrossRef Breckenridge LM, Bruns GL, Todd BL, Feuerstein M (2012) Cognitive limitations associated with tamoxifen and aromatase inhibitors in employed breast cancer survivors. Psycho-Oncol 21(1):43–53CrossRef
27.
Zurück zum Zitat Boele FW, Schilder CM, de Roode ML, Deijen JB, Schagen SB (2015) Cognitive functioning during long-term tamoxifen treatment in postmenopausal women with breast cancer. Menopause 22(1):17–25CrossRefPubMed Boele FW, Schilder CM, de Roode ML, Deijen JB, Schagen SB (2015) Cognitive functioning during long-term tamoxifen treatment in postmenopausal women with breast cancer. Menopause 22(1):17–25CrossRefPubMed
28.
Zurück zum Zitat Chen X, Li J, Chen J, Li D, Ye R, Zhang J, Zhu C, Tian Y, Wang K (2014) Decision-making impairments in breast cancer patients treated with tamoxifen. Horm Behav 66(2):449–456CrossRefPubMed Chen X, Li J, Chen J, Li D, Ye R, Zhang J, Zhu C, Tian Y, Wang K (2014) Decision-making impairments in breast cancer patients treated with tamoxifen. Horm Behav 66(2):449–456CrossRefPubMed
29.
Zurück zum Zitat Lejbak L, Vrbancic M, Crossley M (2010) Endocrine therapy is associated with low performance on some estrogen-sensitive cognitive tasks in postmenopausal women with breast cancer. J Clin Exp Neuropsychol 32(8):836–846CrossRefPubMed Lejbak L, Vrbancic M, Crossley M (2010) Endocrine therapy is associated with low performance on some estrogen-sensitive cognitive tasks in postmenopausal women with breast cancer. J Clin Exp Neuropsychol 32(8):836–846CrossRefPubMed
31.
Zurück zum Zitat Collins B, Mackenzie J, Stewart A, Bielajew C, Verma S (2009) Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study. Psycho-Oncol 18(8):811–821CrossRef Collins B, Mackenzie J, Stewart A, Bielajew C, Verma S (2009) Cognitive effects of hormonal therapy in early stage breast cancer patients: a prospective study. Psycho-Oncol 18(8):811–821CrossRef
32.
Zurück zum Zitat Ganz PA, Petersen L, Castellon SA, Bower JE, Silverman DH, Cole SW, Irwin MR, Belin TR (2014) Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study. J Clin Oncol 32(31):3559–3567CrossRefPubMedPubMedCentral Ganz PA, Petersen L, Castellon SA, Bower JE, Silverman DH, Cole SW, Irwin MR, Belin TR (2014) Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study. J Clin Oncol 32(31):3559–3567CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Schilder CM, Seynaeve C, Beex LV, Boogerd W, Linn SC, Gundy CM, Huizenga HM, Nortier JW, van de Velde CJ, van Dam FS, Schagen SB (2010) Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. J Clin Oncol 28(8):1294–1300CrossRefPubMed Schilder CM, Seynaeve C, Beex LV, Boogerd W, Linn SC, Gundy CM, Huizenga HM, Nortier JW, van de Velde CJ, van Dam FS, Schagen SB (2010) Effects of tamoxifen and exemestane on cognitive functioning of postmenopausal patients with breast cancer: results from the neuropsychological side study of the tamoxifen and exemestane adjuvant multinational trial. J Clin Oncol 28(8):1294–1300CrossRefPubMed
34.
Zurück zum Zitat Debess J, Riis JO, Engebjerg MC, Ewertz M (2010) Cognitive function after adjuvant treatment for early breast cancer: a population-based longitudinal study. Breast Cancer Res Treat 121(1):91–100CrossRefPubMed Debess J, Riis JO, Engebjerg MC, Ewertz M (2010) Cognitive function after adjuvant treatment for early breast cancer: a population-based longitudinal study. Breast Cancer Res Treat 121(1):91–100CrossRefPubMed
35.
Zurück zum Zitat Hedayati E, Alinaghizadeh H, Schedin A, Nyman H, Albertsson M (2012) Effects of adjuvant treatment on cognitive function in women with early breast cancer. Eur J Oncol Nurs 16(3):315–322CrossRefPubMed Hedayati E, Alinaghizadeh H, Schedin A, Nyman H, Albertsson M (2012) Effects of adjuvant treatment on cognitive function in women with early breast cancer. Eur J Oncol Nurs 16(3):315–322CrossRefPubMed
37.
38.
Zurück zum Zitat Ahles TA, Root JC, Ryan EL (2012) Cancer- and cancer treatment-associated cognitive change: an update on the state of the science. J Clin Oncol 30(30):3675–3686CrossRefPubMedPubMedCentral Ahles TA, Root JC, Ryan EL (2012) Cancer- and cancer treatment-associated cognitive change: an update on the state of the science. J Clin Oncol 30(30):3675–3686CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Kampen DL, Sherwin BB (1994) Estrogen use and verbal memory in healthy postmenopausal women. Obstet Gynecol 83(6):979–983CrossRefPubMed Kampen DL, Sherwin BB (1994) Estrogen use and verbal memory in healthy postmenopausal women. Obstet Gynecol 83(6):979–983CrossRefPubMed
47.
Zurück zum Zitat Hogervorst E, De Jager C, Budge M, Smith AD (2004) Serum levels of estradiol and testosterone and performance in different cognitive domains in healthy elderly men and women. Psychoneuroendocrinology 29(3):405–421CrossRefPubMed Hogervorst E, De Jager C, Budge M, Smith AD (2004) Serum levels of estradiol and testosterone and performance in different cognitive domains in healthy elderly men and women. Psychoneuroendocrinology 29(3):405–421CrossRefPubMed
49.
Zurück zum Zitat Drake EB, Henderson VW, Stanczyk FZ, McCleary CA, Brown WS, Smith CA, Rizzo AA, Murdock GA, Buckwalter JG (2000) Associations between circulating sex steroid hormones and cognition in normal elderly women. Neurology 54(3):599–603CrossRefPubMed Drake EB, Henderson VW, Stanczyk FZ, McCleary CA, Brown WS, Smith CA, Rizzo AA, Murdock GA, Buckwalter JG (2000) Associations between circulating sex steroid hormones and cognition in normal elderly women. Neurology 54(3):599–603CrossRefPubMed
56.
Zurück zum Zitat Lange M, Rigal O, Clarisse B, Giffard B, Sevin E, Barillet M, Eustache F, Joly F (2014) Cognitive dysfunctions in elderly cancer patients: a new challenge for oncologists. Cancer Treat Rev 40(6):810–817CrossRefPubMed Lange M, Rigal O, Clarisse B, Giffard B, Sevin E, Barillet M, Eustache F, Joly F (2014) Cognitive dysfunctions in elderly cancer patients: a new challenge for oncologists. Cancer Treat Rev 40(6):810–817CrossRefPubMed
59.
Zurück zum Zitat Tierney MC, Szalai JP, Snow WG, Fisher RH, Nores A, Nadon G, Dunn E, St.George-Hyslop PH (1996) Prediction of probable Alzheimer’s disease in memory-impaired patients: a prospective longitudinal study. Neurology 46(3):661–665CrossRefPubMed Tierney MC, Szalai JP, Snow WG, Fisher RH, Nores A, Nadon G, Dunn E, St.George-Hyslop PH (1996) Prediction of probable Alzheimer’s disease in memory-impaired patients: a prospective longitudinal study. Neurology 46(3):661–665CrossRefPubMed
60.
Zurück zum Zitat Artero S, Tierney MC, Touchon J, Ritchie K (2003) Prediction of transition from cognitive impairment to senile dementia: a prospective, longitudinal study. Acta Psychiatr Scand 107(5):390–393CrossRefPubMed Artero S, Tierney MC, Touchon J, Ritchie K (2003) Prediction of transition from cognitive impairment to senile dementia: a prospective, longitudinal study. Acta Psychiatr Scand 107(5):390–393CrossRefPubMed
61.
Zurück zum Zitat Tierney MC, Yao C, Kiss A, McDowell I (2005) Neuropsychological tests accurately predict incident Alzheimer’s disease after 5 and 10 years. Neurology 64:1853–1859CrossRefPubMed Tierney MC, Yao C, Kiss A, McDowell I (2005) Neuropsychological tests accurately predict incident Alzheimer’s disease after 5 and 10 years. Neurology 64:1853–1859CrossRefPubMed
62.
Zurück zum Zitat Fleisher AS, Sowell BB, Taylor C, Gamst AC, Petersen RC, Thal LJ (2007) Clinical predictors of progression to Alzheimer disease in amnestic mild cognitive impairment. Neurology 68(19):1588–1595CrossRefPubMed Fleisher AS, Sowell BB, Taylor C, Gamst AC, Petersen RC, Thal LJ (2007) Clinical predictors of progression to Alzheimer disease in amnestic mild cognitive impairment. Neurology 68(19):1588–1595CrossRefPubMed
Metadaten
Titel
Cognitive sequelae of endocrine therapy in women treated for breast cancer: a meta-analysis
verfasst von
E. A. Underwood
P. A. Rochon
R. Moineddin
P. E. Lee
W. Wu
K. I. Pritchard
M. C. Tierney
Publikationsdatum
20.12.2017
Verlag
Springer US
Erschienen in
Breast Cancer Research and Treatment / Ausgabe 2/2018
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-017-4627-4

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