Dr Irene Kang Shares Cognitive Impairment Results From the RxPonder Breast Cancer Study

Irene M. Kang, MD, from City of Hope, shared some of the results from her analysis of cognitive impairment in women with breast cancer who participated in the RxPonder study, which assessed which patients would benefit most from chemotherapy.

Irene M. Kang, MD, a medical oncologist, the medical director of women’s health medical oncology, and an assistant professor in the Department of Medical Oncology & Therapeutics Research at City of Hope, detailed the results from her analysis on cognitive impairment among women participating in the RxPonder study.

The study was conducted by the SWOG Cancer Research Network and sought to definitively answer the question of whether recurrence scores could be used to predict which women with hormone receptor–positive (HR+), human epidermal growth factor–negative (HER–), node-positive breast cancer would benefit from chemotherapy.


How did cognitive impairment in women participating in the RxPonder trial change depending on participants’ menopausal status?

So, the primary difference that we found was between treatment arms. We found that patients treated with chemotherapy followed by endocrine therapy had worse cognitive function at the follow-up time points of 6 months, 12 months, and 36 months. We did see that by menopausal status, it seemed that patients on endocrine therapy had a mean cognitive function score that was worse in the short term for the premenopausal group at 6 and 12 months but returned to baseline at 36 months. In the postmenopausal group, patients treated with endocrine therapy alone had essentially stable mean cognitive function scores at the study time points.

How was cognitive impairment measured during your analysis of the RxPonder trial? What does “cognitive impairment” mean in this context?

We assessed cognitive function using a tool called the PROMIS Cognitive Abilities and Cognitive Concerns Scales. This was an 8-item questionnaire that asked participants about things like memory and focus on a 5-point Likert scale.

How can providers use the results of your analysis on patient-reported outcomes regarding cognitive impairment within the RxPonder trial when deciding whether chemotherapy would be beneficial for their patients with HR+, HER–, node-positive breast cancer?

So, our analysis showed that cognitive impairment is experienced at a higher rate with chemo-endocrine therapy rather than endocrine therapy alone, and shows that in some patients, these symptoms persist even out to 36 months. I think these data highlight that using something like a molecular risk assay to avoid chemotherapy in patients who would otherwise not benefit is really important in preventing such a debilitating symptom.

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