Background: Impairment of cognitive functioning has been reported in several studies in patients treated with\r\nchemotherapy. So far, no studies have been published on the effects of the vascular endothelial growth factor\r\nreceptor (VEGFR) inhibitors on cognitive functioning. We investigated the objective and subjective cognitive\r\nfunction of patients during treatment with VEGFR tyrosine kinase inhibitors (VEGFR TKI).\r\nMethods: Three groups of participants, matched on age, sex and education, were enrolled; 1. metastatic renal\r\ncell cancer (mRCC) or GIST patients treated with sunitinib or sorafenib (VEGFR TKI patients n = 30); 2. patients\r\nwith mRCC not receiving systemic treatment (patient controls n = 20); 3. healthy controls (n = 30). Sixteen\r\nneuropsychological tests examining the main cognitive domains (intelligence, memory, attention and\r\nconcentration, executive functions and abstract reasoning) were administered by a neuropsychologist. Four\r\nquestionnaires were used to assess subjective cognitive complaints, mood, fatigue and psychological wellbeing.\r\nResults: No significant differences in mean age, sex distribution, education level or IQ were found between the\r\nthree groups. Both patient groups performed significantly worse on the cognitive domains Learning & Memory and\r\nExecutive Functions (Response Generation and Problem Solving) compared to healthy controls. However only the\r\nVEGFR TKI patients showed impairments on the Executive subdomain Response Generation. Effect sizes of cognitive\r\ndysfunction in patients using VEGFR TKI were larger on the domains Learning & Memory and Executive Functions,\r\ncompared to patient controls. Both patients groups performed on the domain Attention & Concentration the same\r\nas the healthy controls. Longer duration of treatment on VEGFR TKI was associated with a worse score on Working\r\nMemory tasks.\r\nConclusions: Our data suggest that treatment with VEGFR TKI has a negative impact on cognitive functioning,\r\nspecifically on Learning & Memory, and Executive Functioning. We propose that patients who are treated with\r\nVEGFR TKI are monitored and informed for possible signs or symptoms associated with cognitive impairment.\r\nTrial registration: ClinicalTrials.gov Identifier: NCT01246843.
Loading....