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

To evaluate the influence of adjuvant tamoxifen and exemestane on cognitive functioning in postmenopausal patients with breast cancer (BC). Neuropsychological assessments were performed before the start (T1) and after 1 year of adjuvant endocrine treatment (T2) in Dutch postmenopausal patients with...

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Veröffentlicht in:Journal of clinical oncology Jg. 28; H. 8; S. 1294
Hauptverfasser: Schilder, Christina M, Seynaeve, Caroline, Beex, Louk V, Boogerd, Willem, Linn, Sabine C, Gundy, Chad M, Huizenga, Hilde M, Nortier, Johan W, van de Velde, Cornelis J, van Dam, Frits S, Schagen, Sanne B
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 10.03.2010
Schlagworte:
Aged
Aged, 80 and over
Androstadienes - administration & dosage
Androstadienes - adverse effects
Antineoplastic Agents, Hormonal - administration & dosage
Antineoplastic Agents, Hormonal - adverse effects
Aromatase Inhibitors - administration & dosage
Aromatase Inhibitors - adverse effects
Breast Neoplasms - drug therapy
Case-Control Studies
Cognition Disorders - chemically induced
Female
Humans
Middle Aged
Netherlands
Postmenopause
Prospective Studies
Randomized Controlled Trials as Topic
Selective Estrogen Receptor Modulators - administration & dosage
Selective Estrogen Receptor Modulators - adverse effects
Tamoxifen - administration & dosage
Tamoxifen - adverse effects
ISSN:1527-7755, 1527-7755
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Zusammenfassung:To evaluate the influence of adjuvant tamoxifen and exemestane on cognitive functioning in postmenopausal patients with breast cancer (BC). Neuropsychological assessments were performed before the start (T1) and after 1 year of adjuvant endocrine treatment (T2) in Dutch postmenopausal patients with BC, who did not receive chemotherapy. Patients participated in the international Tamoxifen and Exemestane Adjuvant Multinational trial, a prospective randomized study investigating tamoxifen versus exemestane as adjuvant therapy for hormone-sensitive BC. Participants included 80 tamoxifen users (mean age, 68.7 years; range 51 to 84), 99 exemestane users (mean age, 68.3 years; range, 50 to 82), and 120 healthy controls (mean age, 66.2 years; range, 49 to 86). At T2, after adjustment for T1 performance, exemestane users did not perform statistically significantly worse than healthy controls on any cognitive domain. In contrast, tamoxifen users performed statistically significantly worse than healthy controls on verbal memory (P < .01; Cohen's d = .43) and executive functioning (P = .01; Cohen's d = .40), and statistically significantly worse than exemestane users on information processing speed (P = .02; Cohen's d = .36). With respect to visual memory, working memory, verbal fluency, reaction speed, and motor speed, no significant differences between the three groups were found. After 1 year of adjuvant therapy, tamoxifen use is associated with statistically significant lower functioning in verbal memory and executive functioning, whereas exemestane use is not associated with statistically significant lower cognitive functioning in postmenopausal patients with BC. Our results accentuate the need to include assessments of cognitive effects of adjuvant endocrine treatment in long-term safety studies.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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ISSN:1527-7755
1527-7755
DOI:10.1200/JCO.2008.21.3553