Adjuvant therapy regimens containing hormonal agents such as anastrozole with or without chemotherapy have significantly improved the cure rate for women with early stage breast cancer. However, several negative sequelae are associated with this treatment including cognitive impairment that may lead to a deterioration in quality of life. Our pilot data suggest that cognitive impairment is more severe and affects more cognitive domains in women who receive a hormonal agent as part of their adjuvant therapy regimen compared to women with breast cancer who receive chemotherapy alone or no adjuvant therapy. Cognitive impairments in women with breast cancer who receive anastrozole may include deficits in verbal memory and psychomotor speed. Unfortunately, the study that detailed cognitive impairment with anastrozole use was cross sectional and measured cognitive function with a limited battery an average of 36 months following the initiation of treatment.
The aims of this proposed study are: 1) to examine and compare the effect of anastrozole on cognitive function in four cohorts of women (n = 360;90 per group): a) women with breast cancer who receive chemotherapy plus anastrozole;b) women with breast cancer who receive chemotherapy alone;c) women with breast cancer who receive anastrozole alone;and d) a healthy control group of women matched on age, race and level of education and 2) to develop a characteristic profile of women at risk for cognitive impairment. Secondary aims are to explore: 1) the quality of life of women who receive anastrozole and whether cognitive impairment affects quality of life in this sample;2) whether anastrozole adherence and changes in hormone levels are mediators of cognitive function;and 3) whether mood, fatigue, treatment related symptoms, and concomitant medications are moderators of cognitive impairment and quality of life. Using a prospective, four-group, repeated measures design, we plan to evaluate cognitive function, quality of life and potential mediators and moderators of cognitive function at three time points;at baseline, prior to the initiation of therapy and six and 12 months post-baseline. Repeated measures analysis, using a mixed modeling approach, logistic regression and latent variable growth curve modeling, will be used to analyze data to address the study aims.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA107408-05
Application #
7595115
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
O'Mara, Ann M
Project Start
2005-05-01
Project End
2011-05-31
Budget Start
2009-04-01
Budget End
2011-05-31
Support Year
5
Fiscal Year
2009
Total Cost
$380,322
Indirect Cost
Name
University of Pittsburgh
Department
Miscellaneous
Type
Schools of Nursing
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Bender, Catherine M; Merriman, John D; Sereika, Susan M et al. (2018) Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer. Oncol Nurs Forum 45:308-326
Merriman, John D; Sereika, Susan M; Conley, Yvette P et al. (2018) Exploratory Study of Associations Between DNA Repair and Oxidative Stress Gene Polymorphisms and Cognitive Problems Reported by Postmenopausal Women With and Without Breast Cancer. Biol Res Nurs :1099800418799964
Wesmiller, Susan W; Bender, Catherine M; Conley, Yvette P et al. (2017) A Prospective Study of Nausea and Vomiting After Breast Cancer Surgery. J Perianesth Nurs 32:169-176
Myers, Jamie S; Koleck, Theresa A; Sereika, Susan M et al. (2017) Perceived cognitive function for breast cancer survivors: association of genetic and behaviorally related variables for inflammation. Support Care Cancer 25:2475-2484
Wesmiller, Susan W; Sereika, Susan M; Bender, Catherine M et al. (2017) Exploring the multifactorial nature of postoperative nausea and vomiting in women following surgery for breast cancer. Auton Neurosci 202:102-107
Koleck, Theresa A; Bender, Catherine M; Sereika, Susan M et al. (2017) Associations between pathologic tumor features and preadjuvant therapy cognitive performance in women diagnosed with breast cancer. Cancer Med 6:339-348
Merriman, John D; Sereika, Susan M; Brufsky, Adam M et al. (2017) Trajectories of self-reported cognitive function in postmenopausal women during adjuvant systemic therapy for breast cancer. Psychooncology 26:44-52
Koleck, Theresa A; Bender, Catherine M; Sereika, Susan M et al. (2016) Polymorphisms in DNA repair and oxidative stress genes associated with pre-treatment cognitive function in breast cancer survivors: an exploratory study. Springerplus 5:422
Nugent, Bethany D; Sereika, Susan M; Rosenzweig, Margaret et al. (2016) The association between pre-treatment occupational skill level and mood and symptom burden in early-stage, postmenopausal breast cancer survivors during the first year of anastrozole therapy. Support Care Cancer 24:3401-9
Bender, Catherine M; Merriman, John D; Gentry, Amanda L et al. (2015) Patterns of change in cognitive function with anastrozole therapy. Cancer 121:2627-36

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