Prediction of cognitive decline in older breast cancer survivors: the Thinking and Living with Cancer study.

Autor:	McDeed AP; Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA., Van Dyk K; Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA., Zhou X; Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Department of Oncology and Georgetown Lombardi Institute for Cancer and Aging Research, Georgetown University, Washington, DC, USA., Zhai W; Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Department of Oncology and Georgetown Lombardi Institute for Cancer and Aging Research, Georgetown University, Washington, DC, USA., Ahles TA; Memorial Sloan Kettering Cancer Center, New York, NY, USA., Bethea TN; Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Department of Oncology and Georgetown Lombardi Institute for Cancer and Aging Research, Georgetown University, Washington, DC, USA., Carroll JE; Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.; Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA., Cohen HJ; Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA., Nakamura ZM; Department of Psychiatry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA., Rentscher KE; Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA., Saykin AJ; Center for Neuroimaging and Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences and the Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA., Small BJ; School of Aging Studies, University of South Florida, and Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA., Root JC; Memorial Sloan Kettering Cancer Center, New York, NY, USA., Jim H; Department of Health Outcomes and Behavior, Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL, USA., Patel SK; Outcomes Division, Population Sciences, City of Hope National Medical Center, Los Angeles, CA, USA., Mcdonald BC; Center for Neuroimaging and Indiana Alzheimer's Disease Research Center, Department of Radiology and Imaging Sciences and the Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA., Mandelblatt JS; Georgetown University Lombardi Comprehensive Cancer Center, Cancer Prevention and Control Program, Department of Oncology and Georgetown Lombardi Institute for Cancer and Aging Research, Georgetown University, Washington, DC, USA., Ahn J; Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA.
Jazyk:	angličtina
Zdroj:	JNCI cancer spectrum [JNCI Cancer Spectr] 2024 Feb 29; Vol. 8 (2).
DOI:	10.1093/jncics/pkae019
Abstrakt:	Purpose: Cancer survivors commonly report cognitive declines after cancer therapy. Due to the complex etiology of cancer-related cognitive decline (CRCD), predicting who will be at risk of CRCD remains a clinical challenge. We developed a model to predict breast cancer survivors who would experience CRCD after systematic treatment. Methods: We used the Thinking and Living with Cancer study, a large ongoing multisite prospective study of older breast cancer survivors with complete assessments pre-systemic therapy, 12 months and 24 months after initiation of systemic therapy. Cognition was measured using neuropsychological testing of attention, processing speed, and executive function (APE). CRCD was defined as a 0.25 SD (of observed changes from baseline to 12 months in matched controls) decline or greater in APE score from baseline to 12 months (transient) or persistent as a decline 0.25 SD or greater sustained to 24 months. We used machine learning approaches to predict CRCD using baseline demographics, tumor characteristics and treatment, genotypes, comorbidity, and self-reported physical, psychosocial, and cognitive function. Results: Thirty-two percent of survivors had transient cognitive decline, and 41% of these women experienced persistent decline. Prediction of CRCD was good: yielding an area under the curve of 0.75 and 0.79 for transient and persistent decline, respectively. Variables most informative in predicting CRCD included apolipoprotein E4 positivity, tumor HER2 positivity, obesity, cardiovascular comorbidities, more prescription medications, and higher baseline APE score. Conclusions: Our proof-of-concept tool demonstrates our prediction models are potentially useful to predict risk of CRCD. Future research is needed to validate this approach for predicting CRCD in routine practice settings. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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