Cancer therapy-related cognitive impairment, part 1: an integrative clinical–mechanistic framework from phenotypes to convergent neurobiological pathways
Integrative review uncovers convergent neurobiological pathways of cognitive impairment in cancer patients, highlighting shared targets for intervention.
Key Points
Establish an integrative clinical and mechanistic framework that maps cognitive phenotypes to convergent neurobiological pathways across diverse cancer treatments.
Synthesized mechanistic and clinical literature addressing cognitive impairment caused by cytotoxic chemotherapy, endocrine therapy, and targeted therapies.
Integrated preclinical models, biomarker studies, neuroimaging analyses, and objective versus subjective cognitive outcome measures across therapeutic modalities.
Identified neuroinflammation, oxidative stress, mitochondrial dysfunction, suppressed adult neurogenesis, and altered structural and functional brain connectivity as universal drivers of cognitive decline.
Demonstrated that biologically distinct cancer therapies converge on identical neurobiological pathways, accounting for shared patient-reported and clinically measured cognitive deficits.