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Observational Study
. 2015 Aug 1;121(15):2627-36.
doi: 10.1002/cncr.29393. Epub 2015 Apr 23.

Patterns of change in cognitive function with anastrozole therapy

Catherine M Bender  1 , John D Merriman  1 , Amanda L Gentry  1 , Gretchen M Ahrendt  2 , Sarah L Berga  3 , Adam M Brufsky  2 , Frances E Casillo  1 , Meredith M Dailey  1 , Kirk I Erickson  1 , Frances M Kratofil  1 , Priscilla F McAuliffe  2 , Margaret Q Rosenzweig  1 , Christopher M Ryan  1 , Susan M Sereika  1
Affiliations
Observational Study

Patterns of change in cognitive function with anastrozole therapy

Catherine M Bender et al. Cancer. .

Abstract

Background: The purpose of this study was to examine and compare the effects of the first 18 months of anastrozole therapy on cognitive function in women with breast cancer.

Methods: This large, longitudinal cohort study was composed of postmenopausal women with early-stage breast cancer who received chemotherapy plus anastrozole (n = 114) or anastrozole alone (n = 173) and a control group (n = 110). Cognitive function was assessed before systemic therapy and 6, 12, and 18 months after therapy initiation and at comparable time points in controls.

Results: The chemotherapy-anastrozole and anastrozole-alone groups had poorer executive function than the controls at nearly all time points (P < .0001 to P = .09). A pattern of deterioration in working memory and concentration was observed during the first 6 months of anastrozole therapy for the chemotherapy-anastrozole group (P < .0001 and P < .0009, respectively) and the anastrozole-alone group (P = .0008 and P = .0002, respectively). This was followed by improved working memory and concentration from 6 to 12 months in both groups. The anastrozole-alone group had a second decline in working memory and concentration from 12 to 18 months after the initiation of therapy (P < .0001 and P = .02, respectively).

Conclusions: Women with breast cancer had poorer executive functioning from the period before therapy through the entire first 18 months of therapy. A pattern of decline in working memory and concentration with initial exposure to anastrozole was observed. Women receiving anastrozole alone had a second deterioration in working memory and concentration from 12 to 18 months after therapy initiation. The longer term effects (>18 months) of anastrozole on cognitive function remain to be determined.

Keywords: anastrozole; breast cancer; chemotherapy; cognitive function; endocrine therapy.

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Conflict of interest statement

There are no potential conflicts of interest.

Figures

Figure 1
Figure 1. Hypothesized mechanism, the influence of anastrozole on cognitive function
Figure 2
Figure 2
a–2c Results for the anastrozole alone group were shifted for comparison due to the lack of a pre-chemotherapy assessment in that group. Red indicates exposure to anastrozole. 2a. Group response profile, executive function factor over 18 months. 2b Group response profile, visual working memory factor over 18 months. 2c. Group response profile, concentration factor over 18 months.
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