Cognitive function is an important factor when considering oral therapy as an option for cancer treatment, particularly for elderly patients with cancer, a study presented at the European Society for Medical Oncology 2016 Congress has shown.1
A significant issue with the use of oral cancer therapies is patient adherence to the prescribed regimen. Nonadherence can negatively impact treatment efficacy and patient survival, but nonadherence is not always intentional. Therefore, researchers at Centre Francois Baclesse in Caen, France, sought to determine the impact of cognitive function on treatment adherence and identify patient profiles that are more likely to be predictive of nonadherence (Clinical Trial Identification No. ID-RCB: 2011-A00907-34).
For the study, 126 patients initiating a first exclusive oral therapy were enrolled. The researchers performed a standardized neuropsychological test battery; assessed autonomy, depression, and anxiety; and collected socio-demographic information. Treatment adherence was measured via 2 self-assessment questionnaires and an observance sheet at 1 and 3 months after the start of oral therapy. The researchers presented their results at 1 month.
Eighty-eight percent (111) of patients completed the adherence questionnaires, which revealed a treatment adherence rate of 90% among those participants, whose median age was 70 years at baseline. Using the Montreal Cognitive assessment (MoCA), researchers determined 50% of participants had global cognitive impairment.
A significant association was seen between nonadherence and working memory disorders [1.38 (1.03-1.85); P =.0326] and depression [4.67 (1.11-19.59); P =.0352]. In addition, age impacted MoCA score and working memory impairment, with age having a greater impact in patients older than 70 years (P <.005).
These results show that working memory dysfunctions and depression are predictors of nonadherence. Therefore, assessing cognitive function is important in treatment planning to identify those patients who are more likely to experience adherence issues with oral cancer therapy regimens.
1. Dos Santos, M, Lange M, Clarisse B, Barillet M, Joly F. Impact of cognitive function on oral anticancer therapies adherence. Poster presented at: European Society of Medical Oncology 2016 Congress; October 7-11, 2016; Copenhagen, Denmark.