Anthracycline-Based Chemo Affects Cognition, Brain Connectivity

Anthracycline-based chemotherapy is associated with more negative effects on cognition and brain network connections than nonanthracycline chemotherapy treatments, according to data published in JAMA Oncology.  

Chemotherapy is known to be a risk factor for the development of cognitive impairment or “chemo brain,” however differences in the effects of formulations have not been thoroughly examined.

Douglas W. Blayney, MD, of the Division of Medical Oncology at Stanford University School of Medicine in California and Shelli R. Kesler, PhD, of the Department of Neuro-oncology at the University of Texas MD Anderson Cancer Center in Houston, looked at the effects of anthracycline-based and nonanthracycline chemotherapy regimens on cognitive function and brain network connectivity in breast cancer survivors.

They conducted a retrospective, observational study of 62 breast cancer survivors who had completed treatment at least 2 years prior, on average.  Of the participants, 20 had received anthracycline-based chemotherapy, 19 had received nonanthracycline-based chemotherapy, and 23 had no chemotherapy. Cognition and functional brain connectivity were assessed by standardized neuropsychological testing and functional magnetic resonance imaging (MRI).

Participants with a history of anthracycline treatment were found to have lower verbal memory performance (P=0.03), including both immediate recall (F = 3.73; P = .03) and delayed recall (F = 11.11; P < .001). Participants in both chemotherapy groups self-reported greater difficulties in executive function (F = 7.27; P = .002) and psychological symptoms (F = 5.64; P = .006) compared to those who did not receive chemotherapy. Cognitive status was not associated with a history of endocrine treatment or the number of chemotherapy treatments.