A phase II single‐arm trial of memantine for prevention of cognitive decline during chemotherapy in patients with early breast cancer: Feasibility, tolerability, acceptability, and preliminary effects

A phase II single‐arm trial of memantine for prevention of cognitive decline during chemotherapy in patients with early breast cancer: Feasibility, tolerability, acceptability, and preliminary effects

Background Cognitive difficulties have been described after chemotherapy for breast cancer, but there is no standard of care to improve cognitive outcomes in these patients. This trial examined the feasibility, tolerability, acceptability, and preliminary effects of memantine to prevent cognitive de...

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Bibliographic Details
Published in:Cancer medicine (Malden, MA) Vol. 12; no. 7; pp. 8172 - 8183
Main Authors: Nakamura, Zev M., Deal, Allison M., Park, Eliza M., Stanton, Kate E., Lopez, Yesy E., Quillen, Laura J., O’Hare Kelly, Erin, Heiling, Hillary M., Nyrop, Kirsten A., Ray, Emily M., Dees, E. Claire, Reeder‐Hayes, Katherine E., Jolly, Trevor A., Carey, Lisa A., Abdou, Yara, Olajide, Oludamilola A., Rauch, Julia K., Joseph, Ranjit, Copeland, Anureet, McNamara, Megan A., Ahles, Tim A., Muss, Hyman B.
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01-04-2023
John Wiley and Sons Inc
Wiley
Subjects:
Anxiety
behavioral science
Breast cancer
Breast Neoplasms - drug therapy
cancer‐related cognitive impairment
Chemotherapy
Clinical trials
Cognition
Cognition & reasoning
Cognitive ability
Cognitive Dysfunction
Executive function
Feasibility Studies
Female
Hispanic Americans
Humans
Matching-to-sample
Memantine
Memantine - adverse effects
Memory
Middle Aged
Neuropsychology
Patients
quality of life
Radiation
Short term memory
Sleep
Tumors
cancer-related cognitive impairment
behavioral science
memantine
breast cancer
clinical trials
quality of life
cognitive dysfunction
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Summary:Background Cognitive difficulties have been described after chemotherapy for breast cancer, but there is no standard of care to improve cognitive outcomes in these patients. This trial examined the feasibility, tolerability, acceptability, and preliminary effects of memantine to prevent cognitive decline during chemotherapy for breast cancer. Methods Patients with stage I–III breast cancer, scheduled for neo/adjuvant chemotherapy, completed a cognitive battery prior to and 4 weeks after completing chemotherapy. Memantine (10 mg BID) was administered concurrent with chemotherapy. Our primary cognitive outcome was visual working memory assessed by the Delayed Matching to Sample test. We used the Brief Medication Questionnaire to assess acceptability. Results Of 126 patients approached, 56 (44%) enrolled. Forty‐five (80%) received ≥1 dose of memantine and completed pre‐post assessments. Seventy‐six percent reported taking ≥90% of scheduled doses. Participants were mean age of 56, 77% White, and 57% had stage I disease. Sixty‐four percent had stable or improved Delayed Matching to Sample test scores. Stable or improved cognition was observed in 87%–91% across objective cognitive domain composite measures. Sixty‐six percent self‐reported stable or improved cognitive symptoms. There were seven greater than or equal to grade 3 adverse events; two were possibly related to memantine. Only 5% reported that taking memantine was a disruption to their lives. Conclusions Memantine was well‐tolerated and consistently taken by a large majority of patients receiving breast cancer chemotherapy. The majority demonstrated stable or improved cognition from pre‐ to post‐assessment. Randomized trials are needed to determine memantine's efficacy to ameliorate cognitive loss. Trial Registration ClinicalTrials.gov NCT04033419. Memantine is a feasible, safe, and acceptable intervention to mitigate cognitive decline in patients who receive chemotherapy for early‐stage breast cancer. The majority demonstrated stable or improved cognition from pre‐ to post‐assessment. Randomized trials are needed to determine memantine's efficacy to ameliorate cognitive loss.
Bibliography:Tim A. Ahles and Hyman B. Muss co‐senior authorship.
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ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.5619