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Anastrozole Does Not Impair Cognitive Performance in Postmenopausal Women at High Risk of Breast Cancer
NEW YORK -- September 2, 2008 -- Daily anastrozole therapy given to postmenopausal women who are at high risk of breast cancer, with the intention of preventing breast cancer occurrence, does not cause impairment of cognitive performance after 24 months of treatment, according to a substudy of the International Breast Intervention Study (IBIS II), published early online and in the October issue of The Lancet Oncology.
The IBIS II trial was specifically designed to investigate the clinical benefit of anastrozole, given daily for 5 years, as a primary chemopreventive treatment, compared with placebo.
In a double-blind substudy, Valerie Jenkins, MD, Cancer Research UK Psychosocial Oncology Group, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom, assessed 227 women for psychological morbidity, endocrine symptoms, and self-reported cognitive complaints.
Standardised cognitive assessments and interviews were conducted by experienced psychologists and included auditory verbal tasks, logical memory tasks, spatial span tests, and assessment of verbal fluency. The first assessment was made at baseline and subsequently at 6 and 24 months after the start of treatment.
No significant differences between the anastrozole group and the placebo group were noted in changes in attention or memory, or in the proportions of women experiencing
psychological distress.
Few women in either group showed a reliable decline in 3 or more cognitive tasks at 6 months or 24 months. The only difference observed between the groups at the 24-month time point was in endocrine symptoms: significantly more women in the anastrozole group reported hot flushes.
This substudy of the IBIS II trial provides no clear evidence that anastrozole produced cognitive impairments over a 24-month period, but the authors point out that the longer-term effects of anastrozole alone, or following chemotherapy, is unknown.
It is also unclear how endocrine side effects, such as hot flushes, affect the frequency of patient-initiated "drug holidays". However, "these findings should be reassuring in the short term for postmenopausal women being treated with anastrozole, their clinicians, and carers," said Dr. Jenkins.
SOURCE: The Lancet Oncology
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