Inflammation, Attention, and Processing Speed in Patients With Breast Cancer Before and After Chemotherapy
Author:
Belcher Elizabeth K1ORCID, Culakova Eva1ORCID, Gilmore Nikesha J1ORCID, Hardy Sara J12, Kleckner Amber S1ORCID, Kleckner Ian R1ORCID, Lei Lianlian3ORCID, Heckler Charles1ORCID, Sohn Michael B4ORCID, Thompson Bryan D1, Lotta Louis T1, Werner Zachary A1, Geer Jodi5, Hopkins Judith O6, Corso Steven W7, Rich David Q8, van Wijngaarden Edwin8, Janelsins Michelle C1
Affiliation:
1. Department of Surgery, Supportive Care in Cancer Division, University of Rochester Medical Center, Rochester, NY, USA 2. Department of Radiation Oncology and Neurology, University of Rochester Medical Center, Rochester, NY, USA 3. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA 4. Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA 5. Metro Minnesota Community Oncology Research Consortium, Louis Park, MN, USA 6. Novant Health Cancer Institute, Kernersville, NC, USA 7. Upstate Carolina National Cancer Institute Community Oncology Research Program, Spartanburg Regional Medical Center, Spartanburg, SC, USA 8. Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
Abstract
Abstract
Background
Inflammation may contribute to cognitive difficulties in patients with breast cancer. We tested 2 hypotheses: inflammation is elevated in patients with breast cancer vs noncancer control participants and inflammation in patients is associated with worse attention and processing speed over the course of chemotherapy.
Methods
Serum cytokines (interleukin [IL]–4, 6, 8, 10; tumor necrosis factor [TNF]–α) and soluble receptors [sTNFRI, II]) were measured in 519 females with breast cancer before and after chemotherapy and 338 females without cancer serving as control participants. Attention and processing speed were measured by Rapid Visual Processing (RVP), Backward Counting (BCT), and Trail Making-A (TMT-A) tests. Linear regression models examined patient vs control cytokines and receptor levels, adjusting for covariates. Linear regression models also examined relationships between patient cytokines and receptor levels and test performance, adjusting for age, body mass index, anxiety, depression, cognitive reserve, and chemotherapy duration. Statistical tests were 2-sided (α = .05).
Results
sTNFRI and sTNFRII increased over time in patients relative to controls, whereas IL-4, IL-6, and IL-10 decreased. Prechemotherapy, higher IL-8 associated with worse BCT (β = 0.610, SE = 0.241, P = .01); higher IL-4 (β = −1.098, SE = 0.516, P = .03) and IL-10 (β = −0.835, SE = 0.414, P = .04) associated with better TMT-A. Postchemotherapy, higher IL-8 (β = 0.841, SE = 0.260, P = .001), sTNFRI (β = 6.638, SE = 2.208, P = .003), and sTNFRII (β = 0.913, SE = 0.455, P = .045) associated with worse BCT; higher sTNFRII also associated with worse RVP (β = −1.316, SE = 0.587, P = .03). At prechemotherapy, higher IL-4 predicted RVP improvement over time (β = 0.820, SE = 0.336, P = .02); higher sTNFRI predicted worse BCT over time (β = 5.566, SE = 2.367, P = .02). Longitudinally, increases in IL-4 associated with BCT improvement (β = −0.564, SE = 0.253, P = .03).
Conclusions
Generally, worse attention and processing speed were associated with higher inflammatory cytokines and receptors and lower anti-inflammatory cytokines in patients; future confirmatory studies are needed.
Funder
National Cancer Institute University of Rochester Clinical and Translational Science
Publisher
Oxford University Press (OUP)
Subject
Cancer Research,Oncology
Reference84 articles.
1. Longitudinal trajectory and characterization of cancer-related cognitive impairment in a nationwide cohort study;Janelsins;J Clin Oncol,2018 2. Inflammatory biomarkers, comorbidity, and neurocognition in women with newly diagnosed breast cancer;Patel;J Natl Cancer Inst,2015 3. Prevalence, mechanisms, and management of cancer-related cognitive impairment;Janelsins;Int Rev Psychiatry,2014 4. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors;Lange;Ann Oncol,2019 5. The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial;Wefel;Cancer,2004
Cited by
8 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|