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ADT may impair cognitive function in patients with prostate cancer
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Men with prostate cancer who are treated with androgen deprivation therapy are more likely to have cognitive impairments after 6 months of treatment compared with men who do not undergo the treatment, according to study results.
These cognitive issues persisted within the first 12 months after the start of treatment, results also showed.
Brian D. Gonzalez, PhD, a postdoctoral fellow at the Moffitt Cancer Center in Tampa, and colleagues sought to evaluate the impact ADT had on patients’ cognitive performance as well as potential predictors of impairment using demographic and genetic analyses.
The analysis included 58 men with prostate cancer who started ADT before or within 21 days of the study assessment. Researchers compared these patients with 84 men with prostate cancer who underwent prostatectomy only and 88 men without prostate cancer. Researchers conducted baseline assessments and then at 6- and 12-month follow-up assessments.
Men who underwent ADT demonstrated higher rates of impaired cognitive performance over time compared with both control groups (P = .01). There was no difference between the groups at baseline (P > .05); however, the ADT group was more likely to show impairment at 6 months (P < .05) and 12 months (P < .05).
In the multivariable analysis, neither age at baseline, cognitive reserve, depressive symptoms, fatigue nor hot flash interference moderated ADT impact on impaired cognitive performance (P ≥ .09 for all).
The investigators also conducted an exploratory genetic analysis that indicated the GNB3 single-nucleotide polymorphism rs1047776 was associated with impairment over time in the ADT group (P < .001).
Gonzalez and colleagues wrote that their study had several limitations, including being observational by design and having a small sample size.
“These findings serve to raise awareness that some patients with prostate cancer receiving ADT may experience changes in cognitive function within the first 6 months after starting ADT that are likely to persist through 12 months,” the investigators wrote. “These findings may have implications for discussions of risks and benefits of ADT. Clinicians may also consider inquiring about changes in cognitive functioning that may have occurred after starting ADT and refer patients for assessment and treatment as needed.” – by Anthony SanFilippo
Disclosure: Gonzalez reported no relevant financial disclosures. Other researchers reported consultant/advisory roles with Medivation, Onyx and Philips Healthcare and research funding from On Q Health and Pfizer.
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