| Poster | Poster Session 09 Program Schedule
02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease
Final Abstract #70
Cognitive Functioning in Melanoma Patients Treated with Immuno- or Targeted Therapy
Maryse Luijendijk, Netherlands Cancer Institute, Amsterdam, Netherlands
Elaine Albers, Netherlands Cancer Institute, Amsterdam, Netherlands
Lonneke van de Poll-Franse, Netherlands Cancer Institute, Amsterdam, Netherlands
Sanne Schagen, Netherlands Cancer Institute, Amsterdam, Netherlands
Category: Cancer
Keyword 1: cognitive functioning
Keyword 2: cancer
Keyword 3: oncology
Objective:
A subset of cancer patients suffers from cognitive problems during and/or following systemic cancer treatment. Most research into cancer-related cognitive impairment has been performed in breast cancer patients treated with chemotherapy, of which the harmful effects on cognition have been extensively studied. In melanoma patients, however, research into cognitive functioning is limited. Moreover, in recent years immunotherapies such as immune checkpoint inhibitors and targeted therapies have emerged for treatment of melanoma. While their effects on survival are promising, these novel systemic treatments often cause immune-related side-effects, including neurological toxicities. A prior study in melanoma patients found cognitive impairment associated with markers of neuroinflammation. Because the exact cognitive effects remain largely understudied, we investigated cognitive functioning in melanoma patients treated with immuno- and targeted therapies.
Participants and Methods:
Stage III and IV melanoma patients who were treated in the Antoni van Leeuwenhoek hospital with immunotherapy, targeted therapy, a combination of both, or surgery-only were invited 2 years after treatment to participate in the AILEEN study. To assess their cognitive functioning, the Amsterdam Cognition Scan (ACS) was administered, an online neuropsychological test battery covering the domains of attention, information processing speed, learning and memory, executive functioning, and psychomotor speed. Neuropsychological test scores were converted to normalized Z-scores, adjusted for age, sex, educational level and computer use. Scores were interpreted separately for patients with and without brain metastases. Prevalence of cognitive impairment was determined based on criteria proposed by the International Cognition and Cancer Task Force. Latent Profile Analysis was applied to the neuropsychological test scores to investigate in a data-driven manner whether cognitive subgroups could be detected.
Results:
In total, 199 (54%) participants completed cognitive testing. Up till the moment of ACS completion, 116 (58%) participants were treated with immunotherapy only, 8 (4%) with targeted therapy only, 56 (28%) received both and 18 (9%) participants received no systemic treatment. 31 (16%) participants were diagnosed with brain metastases. Prevalence of cognitive impairment was 27% in patients without brain metastases and 26% in patients with brain metastases. Overall, patients performed slightly worse than the normative sample on tests for processing speed, motor functioning, executive functioning and verbal learning, but normal on tests for attention, working memory and memory recall. Patients with brain metastases showed greater impairment in memory and executive functioning, while patients without brain metastases showed slower processing speed. Latent Profile Analysis revealed no distinct subgroups.
Conclusions:
Melanoma patients show slightly worse performance than norms in several cognitive domains after treatment with novel systemic treatments, especially those whose disease has metastasized to the brain. Cognitive impairment was more prevalent than expected in a non-cancer population, but somewhat less common than reported in other cancer patient populations. It remains important to further investigate the cognitive effects of immuno- and targeted therapy for melanoma and find out which patients are most vulnerable to develop cognitive problems.
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