Impact of Cancer and Its Treatments on Cognitive Function: Advances in Research From the Paris International Cognition and Cancer Task Force Symposium and Update Since 2012.
BACKGROUND
Although cognitive impairments have been identified in patients with non-central nervous system cancer, especially breast cancer, the respective roles of cancer and therapies, and the mechanisms involved in cognitive dysfunction remain unclear.


OBJECTIVE
To report a state-of-the-art update from the International Cognitive and Cancer Task Force conference held in 2012.


METHODS
A report of the meeting and recent new perspectives are presented.


RESULTS
Recent clinical data support that non-central nervous system cancer per se may be involved in cognitive dysfunctions associated with inflammation parameters. The role of chemotherapy on cognitive decline was confirmed in colorectal and testicular cancers. Whereas the impact of hormone therapy remains debatable, some studies support a negative impact of targeted therapies on cognition. Regarding interventions, preliminary results of cognitive rehabilitation showed encouraging results. The methodology of future longitudinal studies has to be optimized by a priori end points, the use of validated test batteries, and the inclusion of control groups. Comorbidities and aging are important factors to be taken into account in future studies. Preclinical studies in animal models highlighted the role of cancer itself on cognition and support the possible benefits of prevention/care during chemotherapy. Progress in neuroimaging will help specify neural processes affected by treatments.


CONCLUSIONS
Clinical data and animal models confirmed that chemotherapy induces direct cognitive deficit. The benefits of cognitive rehabilitation are still to be confirmed. Studies evaluating the mechanisms underlying cognitive impairments using advanced neuroimaging techniques integrating the evaluation of genetic factors are ongoing.
Departments of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France; CHU Côte de Nacre, Caen, France; U1086 INSERM-UCBN Cancers & Préventions, Caen, France. Electronic address: f.joly@baclesse.fr.
Florence
F
Joly
UMR-S1077, UNICAEN, Normandie Université, Caen, France; U1077 INSERM, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
Bénédicte
B
Giffard
Service des Soins de Support and Département d'Oncologie Médicale, Centre Henri-Becquerel, Rouen, France.
Olivier
O
Rigal
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; School of Aging Studies, University of South Florida, Tampa, Florida, USA.
Michiel B
MB
De Ruiter
School of Aging Studies, University of South Florida, Tampa, Florida, USA.
Brent J
BJ
Small
INSERM U982, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, DC2N, Astrocyte and Vascular Niche, Biomedical Research Institute (IRIB), University of Rouen, Mont-Saint-Aignan, France.
Martine
M
Dubois
Service des Soins de Support and Département d'Oncologie Médicale, Centre Henri-Becquerel, Rouen, France.
Johan
J
LeFel
Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Sanne B
SB
Schagen
Neurology Service, Memorial Sloan-Kettering Cancer Center, and Weill Medical College of Cornell University, New York, New York, USA.
Tim A
TA
Ahles
Section of Neuropsychology, Department of Neuro-Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
Jeffrey S
JS
Wefel
University of Sydney, Sydney, and Concord Cancer Centre, Concord Hospital, Concord, New South Wales, Australia.
Janette L
JL
Vardy
NorthWest Canceropole, CNRS-UMR 8161-Institut de Biologie de Lille, Lille, France.
Véronique
V
Pancré
Departments of Clinical Research Unit and Medical Oncology, Centre François Baclesse, Caen, France; U1086 INSERM-UCBN Cancers & Préventions, Caen, France.
Marie
M
Lange
INSERM U982, Laboratory of Neuronal and Neuroendocrine Communication and Differentiation, DC2N, Astrocyte and Vascular Niche, Biomedical Research Institute (IRIB), University of Rouen, Mont-Saint-Aignan, France.
Hélène
H
Castel
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D003071:Cognition; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000523:psychology* / Q000628:therapy*
D000970:Antineoplastic Agents
Cancer; chemotherapy; cognition; elderly; neuroimaging