Key result
Anthracycline plus taxane regimens are not associated with higher 10-year ADRD risk versus taxanes.
Why the study?
Anthracyclines carry cardiotoxicity that may increase neurocognitive deficits, but limited evidence exists comparing neurocognitive outcomes between anthracycline plus taxane versus taxane-based regimens in older adults.
Do anthracycline plus taxane regimens increase the risk of Alzheimer's disease and related dementias compared to taxane-based regimens in older women with early-stage HER2-negative breast cancer?
Cohort (n=23,400)
Yes
Do anthracycline plus taxane regimens increase the risk of Alzheimer's disease and related dementias compared to taxane-based regimens in older women with early-stage HER2-negative breast cancer?
Anthracycline plus taxane regimens do not appear to increase the long-term risk of dementia compared to taxane-based regimens in older women with early-stage HER2-negative breast cancer, supporting their continued neurocognitive safety.
Answers are grounded in this paper and cite their sources.
Anthracycline regimens were not associated with higher ADRD risk; hypothesis-generating for neurocognitive safety but should not yet change practice.
BACKGROUND: Anthracycline plus taxane (ATAX) regimens are associated with improved survival in HER2-negative breast cancer (HBC) compared to taxane-based (TAX) regimens. However, anthracyclines are known for their cardiotoxicity, which could increase the risk of neurocognitive deficits, raising concerns about neurocognitive safety, particularly in older adults. Limited evidence exists comparing neurocognitive outcomes between these two regimens. OBJECTIVE: To compare the incidence of Alzheimer's disease and related dementias (ADRD) between ATAX and TAX regimens in neoadjuvant (Trial #1) and adjuvant (Trial #2) settings among older women with early-stage HBC. METHODS: Using SEER-Medicare data (2010-2021), we identified women aged ≥ 66 years with newly diagnosed HBC and no prior neurocognitive conditions between 2011 and 2021. Patients were longitudinally tracked, and their eligibility for each regimen was evaluated. We applied the clone-censor-weight method and used weighted pooled logistic regression to estimate the 10-year risks of ADRD, Alzheimer's disease (AD), and vascular dementia (VD). RESULTS: We identified 14 079 and 9321 eligible individuals in Trial #1 and Trial #2, respectively. For ADRD outcome, the 10-year risk difference (RD) was -6.91% (95% CI: -15.60% to 0.91%) for HR+/HER2- cohort and -2.14% (95% CI: -9.57% to 5.46%) for TNBC cohort in Trial #1. The 10-year RD was -1.42% (95% CI: -9.33% to 6.98%) for HR+/HER2- cohort and -2.91% (95% CI: -9.54% to 7.86%) for TNBC cohort in Trial #2. CONCLUSION: Our findings suggest that ATAX regimens were not associated with increased risks of ADRD, AD, and VD compared to TAX regimens in older women with HBC. However, the risks of AD and VD should be interpreted with caution due to sparse events. These findings may support the continued use of ATAX regimens in this population, while also informing more personalized, risk-adapted treatment strategies.
No takes yet. Share an insight, caveat, or question.
Le et al. (2026) conducted a cohort in Early-stage HER2-negative breast cancer (n=23,400). Anthracycline plus taxane (ATAX) regimens vs. Taxane-based (TAX) regimens was evaluated on Incidence of Alzheimer's disease and related dementias (ADRD) (RD -6.91%, 95% CI -15.60 to 0.91). Anthracycline plus taxane regimens did not increase the 10-year risk of ADRD compared to taxane regimens in older women with HER2-negative breast cancer (RD -6.91%; 95% CI -15.60% to 0.91%).
Synapse has enriched 10 related papers. Consider them for comparative context: