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. 2024 Jun 5;26(1):93.
doi: 10.1186/s13058-024-01850-5.

Inflammation at diagnosis and cognitive impairment two years later in breast cancer patients from the Canto-Cog study

Mylène Duivon  1 , Justine Lequesne  1   2   3 , Antonio Di Meglio  4 , Caroline Pradon  5 , Ines Vaz-Luis  4   6 , Anne-Laure Martin  7 , Sibille Everhard  7 , Sophie Broutin  8 , Olivier Rigal  9   10 , Chayma Bousrih  11 , Christelle Lévy  12 , Florence Lerebours  13 , Marie Lange  14   15   16 , Florence Joly  1   2   3
Affiliations

Inflammation at diagnosis and cognitive impairment two years later in breast cancer patients from the Canto-Cog study

Mylène Duivon et al. Breast Cancer Res. .

Abstract

Background: Inflammation could be related to cancer-related cognitive impairment (CRCI) and might be used as a predictive marker of long-term CRCI. We evaluated associations between inflammatory markers assessed at diagnosis of breast cancer and CRCI two years afterwards.

Methods: Newly diagnosed stage I-III patients with breast cancer from the French CANTO-Cog (Cognitive sub-study of CANTO, NCT01993498) were included at diagnosis (baseline). Serum inflammatory markers (IL-2, IL-4, IL-6, IL-8, IL-10, TNFα, CRP) were assessed at baseline. Outcomes at year 2 post-baseline included overall cognitive impairment (≥ 2 impaired domains) and the following domains: episodic memory, working memory, attention, processing speed, and executive functions. Multivariable logistic regression models evaluated associations between markers and outcomes, controlling for age, education, and baseline cognitive impairment.

Results: Among 200 patients, the mean age was 54 ± 11 years, with 127 (64%) receiving chemotherapy. Fifty-three (27%) patients had overall cognitive impairment at both timepoints. Overall cognitive impairment at year 2 was associated with high (> 3 mg/L) baseline CRP (OR = 2.84, 95%CI: 1.06-7.64, p = 0.037). In addition, associations were found between high CRP and processing speed impairment (OR = 2.47, 95%CI:1.05-5.87, p = 0.039), and between high IL-6 and episodic memory impairment (OR = 5.50, 95%CI:1.43-36.6, p = 0.010).

Conclusions: In this cohort, high levels of CRP and IL-6 assessed at diagnosis were associated with overall CRCI, processing speed and episodic memory impairments two years later. These findings suggest a potential inflammatory basis for long-term CRCI. CRP may represent an easily measurable marker in clinical settings and be potentially used to screen patients at greater risk of persistent CRCI.

Keywords: Breast cancer; C-reactive protein; Cancer-related cognitive impairment; Cytokines.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of CANTO-Cog study
Fig. 2
Fig. 2
Number (and percentage) of patients with high vs. low CRP and IL-6 levels. CRP: C-reactive protein; IL-6: Interleukin 6; High: level above threshold; Low: level below threshold; ** p value < 0.01
See this image and copyright information in PMC

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