PMID- 37004168
OWN - NLM
STAT- MEDLINE
DCOM- 20230425
LR  - 20230504
IS  - 2515-5091 (Electronic)
IS  - 2515-5091 (Linking)
VI  - 7
IP  - 2
DP  - 2023 Mar 1
TI  - Effects of tamoxifen and exemestane on cognitive function in postmenopausal 
      patients with breast cancer.
LID - 10.1093/jncics/pkad022 [doi]
LID - pkad022
AB  - BACKGROUND: Cognitive effects of tamoxifen have been described. We augment data 
      from a previous short-term (ST) follow-up study with long-term (LT) data to 
      evaluate ST and LT cognitive effects of tamoxifen followed by exemestane and 
      exemestane in breast cancer patients. METHODS: Patients from the Tamoxifen and 
      Exemestane Adjuvant Multinational trial received 5 years exemestane (exemestane 
      group, n = 114) or 2.5 years tamoxifen followed by 2.5 years exemestane 
      (sequential group, n = 92). Neuropsychological performance was assessed 
      pre-endocrine therapy, after 1 year (ST follow-up) and at 5 years (LT follow-up). 
      A control group of healthy participants (n = 120) were assessed with parallel 
      intervals. With random effects modeling we evaluated cognitive changes from 
      baseline to ST and LT follow-up. Statistical tests were 2-sided. RESULTS: After 
      controlling for age, intelligence quotient, attrition, menopausal symptoms, 
      anxiety and/or depression, and/or fatigue, the sequential group showed ST and LT 
      decline compared with control participants on verbal memory (effect size [ES] = 
      0.26, P = .01; ES = 0.34, P = .003) and executive function (ES = 0.27, P = .007; 
      ES = 0.38, P = .002). Compared with the exemestane group, the sequential group 
      demonstrated ST decline on information processing speed (ES = 0.33, P = .01) and 
      executive function (ES = 0.32, P = .01) and LT decline on verbal memory (ES = 
      0.33, P = .02). The exemestane group showed no cognitive decline compared with 
      control participants. CONCLUSION: Cognitive adverse effects of tamoxifen alone 
      and after switching to exemestane were observed, suggestive of a carryover effect 
      of tamoxifen. Our results underline the need for well-controlled, prospective 
      trials studying cognitive effects of endocrine therapy.
CI  - (c) The Author(s) 2023. Published by Oxford University Press.
FAU - Lee Meeuw Kjoe, Philippe R
AU  - Lee Meeuw Kjoe PR
AUID- ORCID: 0000-0003-3407-7623
AD  - Department of Psychosocial Research and Epidemiology, The Netherlands Cancer 
      Institute, Amsterdam, The Netherlands.
FAU - Kieffer, Jacobien M
AU  - Kieffer JM
AD  - Department of Psychosocial Research and Epidemiology, The Netherlands Cancer 
      Institute, Amsterdam, The Netherlands.
FAU - Small, Brent J
AU  - Small BJ
AD  - School of Aging Studies, University of South Florida, Tampa, FL, USA.
FAU - Boogerd, Willem
AU  - Boogerd W
AD  - Department of Neuro-oncology, The Netherlands Cancer Institute, Amsterdam, The 
      Netherlands.
FAU - Schilder, Christina M
AU  - Schilder CM
AD  - Department of Psychosocial Research and Epidemiology, The Netherlands Cancer 
      Institute, Amsterdam, The Netherlands.
FAU - van der Wall, Elsken
AU  - van der Wall E
AD  - Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The 
      Netherlands.
FAU - Meershoek-Klein Kranenbarg, Elma
AU  - Meershoek-Klein Kranenbarg E
AD  - Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
FAU - van de Velde, Cornelis J H
AU  - van de Velde CJH
AD  - Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
FAU - Schagen, Sanne B
AU  - Schagen SB
AUID- ORCID: 0000-0003-0153-8059
AD  - Department of Psychosocial Research and Epidemiology, The Netherlands Cancer 
      Institute, Amsterdam, The Netherlands.
AD  - Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - JNCI Cancer Spectr
JT  - JNCI cancer spectrum
JID - 101721827
RN  - 094ZI81Y45 (Tamoxifen)
RN  - NY22HMQ4BX (exemestane)
SB  - IM
CIN - JNCI Cancer Spectr. 2023 Mar 1;7(2):. PMID: 36964714
MH  - Humans
MH  - Female
MH  - *Tamoxifen/adverse effects
MH  - *Breast Neoplasms/drug therapy/psychology
MH  - Follow-Up Studies
MH  - Postmenopause
MH  - Prospective Studies
MH  - Cognition
PMC - PMC10121337
EDAT- 2023/04/03 06:00
MHDA- 2023/04/25 06:42
PMCR- 2023/04/02
CRDT- 2023/04/02 14:10
PHST- 2023/03/09 00:00 [accepted]
PHST- 2022/10/19 00:00 [received]
PHST- 2023/02/13 00:00 [revised]
PHST- 2023/04/25 06:42 [medline]
PHST- 2023/04/03 06:00 [pubmed]
PHST- 2023/04/02 14:10 [entrez]
PHST- 2023/04/02 00:00 [pmc-release]
AID - 7099609 [pii]
AID - pkad022 [pii]
AID - 10.1093/jncics/pkad022 [doi]
PST - ppublish
SO  - JNCI Cancer Spectr. 2023 Mar 1;7(2):pkad022. doi: 10.1093/jncics/pkad022.