JMIR Publications

ABSTRACT

Background:

Previous studies have found and confirmed a correlation between cognitive disorder and chemotherapy. As genetic testing becomes more routine in clinical practice, targeted therapies are increasingly assuming prominence. The relationship between targeted treatment and cognitive function is not yet clear.

Objective:

This study aims to investigate the correlation between cognitive disorder and targeted treatment by evaluating the changes in cognitive function before and after targeted therapy.

Methods:

From the screened cohort of 150 patients suffering from advanced non-small-cell lung cancer with gene mutations, 87 were rigorously selected for the study. The evaluation instruments utilized included the MMSE scale, the Distress Thermometer (DT), and the EORTC QLQ-C30 scale for assessing the quality of life.

Results:

A significantly lower Progression-Free Survival (PFS) was observed in the group of surviving advanced NSCLC patients with cognitive disorders under targeted therapy, in contrast to no cognitive disorder group survivors (HR, 0.347; 95% CI, 0.209-0.578; P < 0.001). Furthermore, the Objective Response Rate (ORR) and Disease Control Rate (DCR) for the group with cognitive disorders were noted to be 37.8% and 86.7% respectively, contrastingly lower than no cognitive disorder group, recorded at 78.6% and 97.6%. Significant variances were also noted in the MMSE scores between the patients with and without cognitive disorders, both pre and post targeted therapy (P < 0.001, P < 0.001) , with a decrease trend observed in both groups post targeted therapy. Noteworthy differences were found in Quality of Life scores both pre and post targeted therapy (P < 0.001, P < 0.001). Also, notable disparities were apparent in C-reactive protein levels among the two groups, pre and post treatment (P=0.03, P=0.048), with an upward trend observed in both groups post targeted therapy.

Conclusions:

The potential impact of cognitive disorders was discovered on the efficacy of targeted therapies in oncogene-driver positive NSCLC patients. Furthermore, during targeted therapy, the MMSE score was positively correlated with the quality of life and inversely related to psychological distress. Meanwhile, the inflammatory marker, C-reactive protein, was found to exhibit a correlation with psychological distress.