Impairment of cognitive functioning during Sunitinib or Sorafenib treatment in cancer patients: a cross sectional study

BMC Cancer

Sasja F Mulder²  Dirk Bertens⁴  Ingrid ME Desar²  Kris CP Vissers⁵  Peter FA Mulders¹  Cornelis JA Punt⁶  Dick-Johan van Spronsen³  Johan F Langenhuijsen¹  Roy PC Kessels⁴  Carla ML van Herpen² 

[1] Department of Urology, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

[2] Department of Medical Oncology, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

[3] Department of Internal Medicine, Canisius Wilhelmina Hospital, PO Box 9015, 6500 Nijmegen, The Netherlands

[4] Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, PO Box 9104, 6500 HE Nijmegen, The Netherlands

[5] Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands

[6] Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands

关键词: Executive functioning;    Memory and Learning;    VEGFR TKI;    Sorafenib;    Sunitinib;    Cognitive function;   

Others  :  858938
DOI  :  10.1186/1471-2407-14-219

 received in 2012-11-03, accepted in 2014-03-13,  发布年份 2014

【 摘 要 】

Background

Impairment of cognitive functioning has been reported in several studies in patients treated with chemotherapy. So far, no studies have been published on the effects of the vascular endothelial growth factor receptor (VEGFR) inhibitors on cognitive functioning. We investigated the objective and subjective cognitive function of patients during treatment with VEGFR tyrosine kinase inhibitors (VEGFR TKI).

Methods

Three groups of participants, matched on age, sex and education, were enrolled; 1. metastatic renal cell cancer (mRCC) or GIST patients treated with sunitinib or sorafenib (VEGFR TKI patients n = 30); 2. patients with mRCC not receiving systemic treatment (patient controls n = 20); 3. healthy controls (n = 30). Sixteen neuropsychological tests examining the main cognitive domains (intelligence, memory, attention and concentration, executive functions and abstract reasoning) were administered by a neuropsychologist. Four questionnaires were used to assess subjective cognitive complaints, mood, fatigue and psychological wellbeing.

Results

No significant differences in mean age, sex distribution, education level or IQ were found between the three groups. Both patient groups performed significantly worse on the cognitive domains Learning & Memory and Executive Functions (Response Generation and Problem Solving) compared to healthy controls. However only the VEGFR TKI patients showed impairments on the Executive subdomain Response Generation. Effect sizes of cognitive dysfunction in patients using VEGFR TKI were larger on the domains Learning & Memory and Executive Functions, compared to patient controls. Both patients groups performed on the domain Attention & Concentration the same as the healthy controls. Longer duration of treatment on VEGFR TKI was associated with a worse score on Working Memory tasks.

Conclusions

Our data suggest that treatment with VEGFR TKI has a negative impact on cognitive functioning, specifically on Learning & Memory, and Executive Functioning. We propose that patients who are treated with VEGFR TKI are monitored and informed for possible signs or symptoms associated with cognitive impairment.

Trial registration

ClinicalTrials.gov Identifier: NCT01246843.

【 授权许可】

   
2014 Mulder et al.; licensee BioMed Central Ltd.

【 图 表 】

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