Chemotherapy-induced Cognitive and Brain Changes in Older Adults With Breast Cancer

Study Overview
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Brief Summary
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This research study evaluates the effect of chemotherapy on cognition (thinking) and the brain in people with breast cancer.

Detailed Description
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This study is being done to study effects of chemotherapy (cancer treatment) on the brain and cognition (thinking). Chemo-brain is a term sometimes used to refer to effects of chemotherapy on the brain and cognition (thinking). This study is being done to test for chemo-brain in older adults with breast cancer treated with chemotherapy, and to identify people who are most likely to be affected. The investigators will look at thinking abilities and brain images before and after chemotherapy to see if it can help identify people at risk for cognitive side effects of the treatment, and to better understand effects of treatment on brain structure and function. The investigators are looking for participants who have either been recently recently diagnosed breast cancer participant or a healthy volunteer. What is involved in the study: Memory and Thinking Tests Imaging: Either MRI/or MRI and PET Scans

Official Title
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Chemotherapy-induced Cognitive and Brain Changes in Older Adults With Breast Cancer

Conditions
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Impaired Cognition, Chemo-brain, Breast Cancer

Intervention / Treatment
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* Other: Cognitive, functional and subjective assessments
* Device: MRI
* Radiation: PET Scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Breast cancer patients treated with chemotherapy- Group 1 (experimental group) Participants must meet the following criteria on screening examination to be eligible to participate in the behavioral +/- imaging components of study New diagnosis histologically confirmed invasive breast cancer Treatment plan to include chemotherapy Female subjects age ≥ 60 years. Life expectancy ≥ 1 year Karnofsky Performance Score (KPS) ≥ 80 Ability to understand and the willingness to sign a written informed consent document. Non-treated breast cancer patient controls- Group 2 (control group) Participants must meet the following criteria on screening examination to be eligible to participate in the behavioral +/- imaging components of study: New diagnosis histologically confirmed invasive breast cancer Treatment plan does not include chemotherapy Age ≥ 60 years. Life expectancy ≥ 1 year Karnofsky Performance Score (KPS) ≥ 80 Ability to understand and the willingness to sign a written informed consent document. Healthy control subjects- Group 3 (control group) Participants must meet the following criteria on screening examination to be eligible to participate in the behavioral +/- imaging components of study: Age ≥ 60 years. Life expectancy ≥ 1 year Karnofsky Performance Score (KPS) ≥ 80 Ability to understand and the willingness to sign a written informed consent document. Participants with well-controlled vascular risk factors, such as treated hypertension, treated hyperlipidemia or well-controlled Type II diabetes (glucose levels <250) may be included. Serum Pregnancy Testing: STAT quantitative serum hCG pregnancy testing for all women of childbearing potential. Imaging will not start until and unless the test result returns negative. Exclusion Criteria: Participants who exhibit any of the following conditions at screening will not be eligible for admission into the study: Participants with clinical or radiographic evidence of metastatic CNS disease Subjects with MMSE scores below 24 Active or history of major psychiatric disorders such as schizophrenia, schizoaffective disorder, major affective disorder in mid-life, or treatment with ECT (Mild depression that is well treated with stable dose of SSRI antidepressants may be allowed). Substance abuse within the past 2 years Huntington's disease, hydrocephalus or seizure disorder In addition to exclusion criteria above, participants who exhibit any of the following conditions at screening will not be eligible for admission into imaging portion of the study: Participants with contraindications to MRI (i.e., implanted metal including pacemakers, cerebral spinal fluid shunts, aneurysm clips, artificial heart valves, ear implants or metal/foreign objects in the eyes and those with a history of claustrophobia), injuries to the eyes with metal without X-ray documentation that metal was removed

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: ARM 1<br>Breast cancer patients treated with chemotherapy Cognitive, functional and subjective assessments (Pre and Post Treatment) Imaging (Pre and Post Treatment) Magnetic Resonance Imaging (MRI) Scan Magnetic Resonance Imaging (MRI) Scan / Positron Emission Tomography (PET) Scan | Other: Cognitive, functional and subjective assessments<br>* Cognitive and functional assessments<br>Device: MRI<br>* Magnetic Resonance Imaging (MRI) Scan<br>Radiation: PET Scan<br>* Positron Emission Tomography (PET) Scan<br>|
| Active Comparator: ARM 2<br>Non-treated breast cancer patient control Cognitive, functional and subjective assessments (Post enrollment and 6-14 months later Imaging (Post Enrollment and at 8-14 months later) Magnetic Resonance Imaging (MRI) Scan Magnetic Resonance Imaging (MRI) Scan / Positron Emission Tomography (PET) Scan | Other: Cognitive, functional and subjective assessments<br>* Cognitive and functional assessments<br>Device: MRI<br>* Magnetic Resonance Imaging (MRI) Scan<br>Radiation: PET Scan<br>* Positron Emission Tomography (PET) Scan<br>|
| Active Comparator: ARM 3<br>Healthy control subjects Cognitive, functional and subjective assessments (Post enrollment and 6-14 months later Imaging (Post Enrollment and at 8-14 months later) Magnetic Resonance Imaging (MRI) Scan Magnetic Resonance Imaging (MRI) Scan / Positron Emission Tomography (PET) Scan | Other: Cognitive, functional and subjective assessments<br>* Cognitive and functional assessments<br>Device: MRI<br>* Magnetic Resonance Imaging (MRI) Scan<br>Radiation: PET Scan<br>* Positron Emission Tomography (PET) Scan<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in cognitive performance scores |  | Baseline, immediately after completion of chemo, and 6 months after completion of chemotherapy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between baseline amyloid accumulation in the brain and change in cognitive performance |  | Baseline, 6 months after completion of chemotherapy | 
| Correlation between baseline tau accumulation in the brain and change in cognitive performance |  | Baseline, 6 months after completion of chemotherapy | 
| Correlation between change in tau accumulation in the brain (from baseline to 6 months after completion of chemotherapy) and change in cognitive performance (from baseline to 6 months after completion of chemotherapy) |  | Baseline, 6 months after completion of chemotherapy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chemotherapy related cognitive impairment, Chemo-brain