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Grant Details

Grant Number: 5R01CA109650-05 Interpret this number
Primary Investigator: Ganz, Patricia
Organization: University Of California Los Angeles
Project Title: Cognitive Functioning After Breast Cancer Treatment
Fiscal Year: 2010


Abstract

DESCRIPTION (provided by applicant): Cognitive complaints have been anecdotally reported among women receiving adjuvant chemotherapy for breast cancer, and recently this has been subjected to more rigorous study. Cerebral functioning can be assessed by self-report, standardized neuropsychological testing, and through examination of brain metabolism (all of which have been studied in our laboratory). The literature suggests a relationship between chemotherapy exposure and poorer performance on neurocognitive testing; however, patients with cognitive complaints do not necessarily test poorly and their complaints are often associated with symptoms of depression and anxiety. Preliminary work in our laboratory suggests that hormonal changes associated with menopause and adjuvant endocrine therapy for breast cancer also influence the effects of chemotherapy on cognitive functioning. Little is known about the potential mechanisms by which adjuvant endocrine therapy influences cerebral functioning after breast cancer treatment, and in this study we will address this question by studying women who have recently completed their primary breast cancer treatments (surgery, radiation, chemotherapy) and who are about to initiate adjuvant endocrine therapy (with tamoxifen or aromatase inhibitors). We will examine the potential mechanisms by which endocrine therapy affects cerebral functioning, by consideration of a comprehensive framework that includes the role of constitutional symptoms (fatigue, depression, anxiety), and immune alterations, in addition to specific cancer treatments (chemotherapy, hormonal treatments), and endogenous endocrine exposures (estrogen, cortisol). In this longitudinal, observational cohort study, we propose the following specific aims: 1)To evaluate the effects of adjuvant endocrine therapy on cognitive functioning through standardized questionnaires and neuropsychological assessments in 260 breast cancer patients at the end of primary treatment (baseline) when endocrine treatment is initiated, and one year later (follow-up). 2)To examine the association between cognitive functioning and measures of cerebral metabolism by obtaining positron emission tomography (PET) brain imaging, at rest and with a memory challenge, in close temporal proximity to the baseline assessment of cognitive functioning in a subset of 60 women, with a follow-up assessment one year later. 3)To explore the biopsychosocial mechanisms by which adjuvant endocrine therapy influences cerebral functioning by examining changes in cognitive functioning and brain metabolism, and their relationship to immune and endocrine function, mood and symptoms between the baseline and follow-up assessment one year later. Lay summary: Breast cancer is the most common cancer in women. After treatments for breast cancer, some women complain of difficulty in concentrating and thinking. This study will examine the effects of breast cancer treatments on cognitive, psychological, immune and endocrine function to try to understand the biological mechanisms of these complaints so that they may be better prevented or treated in the future.



Publications

Goal disturbance in early-stage breast cancer survivors.
Authors: Haydon M.D. , Stanton A.L. , Ganz P.A. , Bower J.E. .
Source: Journal of psychosocial oncology, 2019 Jul-Aug; 37(4), p. 478-493.
EPub date: 2019-01-25.
PMID: 30681035
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The cognitive effects of endocrine therapy in survivors of breast cancer: A prospective longitudinal study up to 6 years after treatment.
Authors: Van Dyk K. , Crespi C.M. , Bower J.E. , Castellon S.A. , Petersen L. , Ganz P.A. .
Source: Cancer, 2019-03-01; 125(5), p. 681-689.
EPub date: 2018-11-28.
PMID: 30485399
Related Citations

Cognitive performance in survivors of breast cancer and markers of biological aging.
Authors: Carroll J.E. , Van Dyk K. , Bower J.E. , Scuric Z. , Petersen L. , Schiestl R. , Irwin M.R. , Ganz P.A. .
Source: Cancer, 2019-01-15; 125(2), p. 298-306.
EPub date: 2018-11-26.
PMID: 30474160
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Fatigue after breast cancer treatment: Biobehavioral predictors of fatigue trajectories.
Authors: Bower J.E. , Wiley J. , Petersen L. , Irwin M.R. , Cole S.W. , Ganz P.A. .
Source: Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2018 Nov; 37(11), p. 1025-1034.
PMID: 30321021
Related Citations

Cognitive function following breast cancer treatment and associations with concurrent symptoms.
Authors: Van Dyk K. , Bower J.E. , Crespi C.M. , Petersen L. , Ganz P.A. .
Source: NPJ breast cancer, 2018; 4, p. 25.
EPub date: 2018-08-17.
PMID: 30131974
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Evaluating cognitive complaints in breast cancer survivors with the FACT-Cog and quantitative electroencephalography.
Authors: Van Dyk K. , Hunter A.M. , Ercoli L. , Petersen L. , Leuchter A.F. , Ganz P.A. .
Source: Breast cancer research and treatment, 2017 Nov; 166(1), p. 157-166.
EPub date: 2017-07-13.
PMID: 28707203
Related Citations

Inflammation and attentional bias in breast cancer survivors.
Authors: Boyle C.C. , Ganz P.A. , Van Dyk K.M. , Bower J.E. .
Source: Brain, behavior, and immunity, 2017 Nov; 66, p. 85-88.
EPub date: 2017-05-22.
PMID: 28546059
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Posttraumatic growth in breast cancer survivors: does age matter?
Authors: Boyle C.C. , Stanton A.L. , Ganz P.A. , Bower J.E. .
Source: Psycho-oncology, 2017 06; 26(6), p. 800-807.
EPub date: 2016-02-18.
PMID: 26893237
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Measuring cognitive complaints in breast cancer survivors: psychometric properties of the patient's assessment of own functioning inventory.
Authors: Van Dyk K. , Ganz P.A. , Ercoli L. , Petersen L. , Crespi C.M. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016 12; 24(12), p. 4939-4949.
EPub date: 2016-07-19.
PMID: 27432402
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Comparison of Neurocognitive Function After Anthracycline-Based Chemotherapy vs Nonanthracycline-Based Chemotherapy.
Authors: Van Dyk K. , Petersen L. , Ganz P.A. .
Source: JAMA oncology, 2016-07-01; 2(7), p. 964-5.
PMID: 27100156
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Val66Met BDNF polymorphism as a vulnerability factor for inflammation-associated depressive symptoms in women with breast cancer.
Authors: Dooley L.N. , Ganz P.A. , Cole S.W. , Crespi C.M. , Bower J.E. .
Source: Journal of affective disorders, 2016 Jun; 197, p. 43-50.
EPub date: 2016-03-02.
PMID: 26967918
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Positive Affect and Inflammatory Activity in Breast Cancer Survivors: Examining the Role of Affective Arousal.
Authors: Moreno P.I. , Moskowitz A.L. , Ganz P.A. , Bower J.E. .
Source: Psychosomatic medicine, 2016 06; 78(5), p. 532-41.
PMID: 26867077
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Impact of Adjuvant Endocrine Therapy on Quality of Life and Symptoms: Observational Data Over 12 Months From the Mind-Body Study.
Authors: Ganz P.A. , Petersen L. , Bower J.E. , Crespi C.M. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2016-03-10; 34(8), p. 816-24.
EPub date: 2016-01-19.
PMID: 26786934
Related Citations

Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study.
Authors: Ganz P.A. , Petersen L. , Castellon S.A. , Bower J.E. , Silverman D.H. , Cole S.W. , Irwin M.R. , Belin T.R. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2014-11-01; 32(31), p. 3559-67.
EPub date: 2014-09-29.
PMID: 25267747
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Childhood adversity and inflammation in breast cancer survivors.
Authors: Crosswell A.D. , Bower J.E. , Ganz P.A. .
Source: Psychosomatic medicine, 2014 Apr; 76(3), p. 208-14.
PMID: 24632893
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The association between pro-inflammatory cytokines, regional cerebral metabolism, and cognitive complaints following adjuvant chemotherapy for breast cancer.
Authors: Pomykala K.L. , Ganz P.A. , Bower J.E. , Kwan L. , Castellon S.A. , Mallam S. , Cheng I. , Ahn R. , Breen E.C. , Irwin M.R. , et al. .
Source: Brain imaging and behavior, 2013 Dec; 7(4), p. 511-23.
PMID: 23835929
Related Citations

Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance.
Authors: Ganz P.A. , Kwan L. , Castellon S.A. , Oppenheim A. , Bower J.E. , Silverman D.H. , Cole S.W. , Irwin M.R. , Ancoli-Israel S. , Belin T.R. .
Source: Journal of the National Cancer Institute, 2013-06-05; 105(11), p. 791-801.
EPub date: 2013-04-19.
PMID: 23606729
Related Citations

Cytokine genetic variations and fatigue among patients with breast cancer.
Authors: Bower J.E. , Ganz P.A. , Irwin M.R. , Castellon S. , Arevalo J. , Cole S.W. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013-05-01; 31(13), p. 1656-61.
EPub date: 2013-03-25.
PMID: 23530106
Related Citations

Does tumor necrosis factor-alpha (TNF-α) play a role in post-chemotherapy cerebral dysfunction?
Authors: Ganz P.A. , Bower J.E. , Kwan L. , Castellon S.A. , Silverman D.H. , Geist C. , Breen E.C. , Irwin M.R. , Cole S.W. .
Source: Brain, behavior, and immunity, 2013 Mar; 30 Suppl, p. S99-108.
EPub date: 2012-08-03.
PMID: 22884417
Related Citations

Sleep disturbance, inflammation and depression risk in cancer survivors.
Authors: Irwin M.R. , Olmstead R.E. , Ganz P.A. , Haque R. .
Source: Brain, behavior, and immunity, 2013 Mar; 30 Suppl, p. S58-67.
EPub date: 2012-05-24.
PMID: 22634367
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Examining the influence of beta blockers and ACE inhibitors on the risk for breast cancer recurrence: results from the LACE cohort.
Authors: Ganz P.A. , Habel L.A. , Weltzien E.K. , Caan B.J. , Cole S.W. .
Source: Breast cancer research and treatment, 2011 Sep; 129(2), p. 549-56.
EPub date: 2011-04-11.
PMID: 21479924
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Missing data: what a little can do, and what researchers can do in response.
Authors: Belin T.R. .
Source: American journal of ophthalmology, 2009 Dec; 148(6), p. 820-2.
PMID: 19932803
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Chronic inflammation and breast cancer recurrence.
Authors: Cole S.W. .
Source: Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009-07-20; 27(21), p. 3418-9.
EPub date: 2009-05-26.
PMID: 19470918
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