Evidence map›Paper›PMID 40219873›Full record

ArticleCancer2025

Natural trajectory subclasses of cognitive impairment in breast cancer patients experiencing insomnia.

Oxana Palesh, Sarah E Braun, Tina Truong, Susan Hong, Masato Mitsuhashi, Ruth Nyagaka, Susanne Lee, Adithi Gandhi, Alexa De La Torre Schutz, Shelli R Kesler

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Oxana PaleshVirginia Commonwealth University, Massey Comprehensive Cancer Center, Richmond, Virginia, USA.ORCID https://orcid.org/0000-0002-5695-8678
Sarah E BraunVirginia Commonwealth University, Massey Comprehensive Cancer Center, Richmond, Virginia, USA.
Tina TruongDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Palo Alto, California, USA.
Susan HongVirginia Commonwealth University, Massey Comprehensive Cancer Center, Richmond, Virginia, USA.
Masato MitsuhashiNanoSomiX, Aliso Viejo, California, USA.
Ruth NyagakaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Palo Alto, California, USA.
Susanne LeeDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Palo Alto, California, USA.
Adithi GandhiDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Palo Alto, California, USA.
Alexa De La Torre SchutzDepartment of Adult Health, University of Texas at Austin, Austin, Texas, USA.
Shelli R KeslerDepartment of Adult Health, University of Texas at Austin, Austin, Texas, USA.ORCID https://orcid.org/0000-0002-4745-8014

Funding

Multicenter Randomized Controlled Trial of Brief Behavioral Therapy for Cancer Related InsomniaR01CA239714 · NCI · VIRGINIA COMMONWEALTH UNIVERSITY · PI PALESH, OXANA G · 2020 to 2025
$4.5M
Very-long Term Neurocognitive Outcomes in Breast Cancer Survivors (ProbC2)R01CA172145 · NCI · VIRGINIA COMMONWEALTH UNIVERSITY · PI KESLER, SHELLI R, PALESH, OXANA G · 2012 to 2024
$3.3M
Predicting Long-Term Chemotherapy-Related Cognitive ImpairmentR01CA226080 · NCI · UNIVERSITY OF TEXAS AT AUSTIN · PI KESLER, SHELLI R, PALESH, OXANA G · 2019 to 2024
$3.1M
NCI NIH HHS R01 CA172145NCI NIH HHS R01CA172145NCI NIH HHS R01 CA226080NCI NIH HHS R01CA226080-01A1NCI NIH HHS R01 CA239714NCI NIH HHS R01CA239714-01A1
6 · The paper itself

Abstract

backgroundCancer-related cognitive impairment (CRCI) has traditionally been assessed in a dichotomous manner. Identifying subclasses of CRCI and novel biomarkers can improve the accuracy of identifying patients most at risk for CRCI.

methodsA total of 139 breast cancer patients undergoing chemotherapy completed neurocognitive batteries over 12 months. Growth mixture modeling (GMM) was used to determine latent subgroups based on different trajectories of cognitive test performance across the four time points. Additionally, the authors collected peripheral blood to measure neuron-derived exosomes (NDE).

resultsMean cognitive performance improved significantly over time (p < .001). However, GMM identified three distinct latent subgroups: patients with stable, high performance (class 1, N = 45), patients with variable low performance (class 2, N = 15), and patients with average performance who improved over time (class 3, N = 79). Cognitive subclass 2 was characterized by significantly lower education levels than the other two classes (p = .001). Cognitive subclass 1 had fewer racial/ethnic minority patients than the other two classes (p = .015). Cognitive subclasses did not differ significantly in any other demographic or clinical characteristic. There were no significant differences observed by NDE.

conclusionsThere are multiple distinct longitudinal trajectories of CRCI and these may be influenced by social determinants of health such as education and race/ethnicity. Future research can focus on ways to administer interventions earlier to those at most risk for CRCI and continue to explore novel biomarkers of CRCI.

Indexed as

Breast NeoplasmsCognitive DysfunctionSleep Initiation and Maintenance DisordersAdultAgedFemaleHumansMiddle AgedNeuropsychological Testsbreast cancercognitivegynecologic cancerneuron‐derived exosomessurvivorship needs

Identifiers

PMID40219873
PMCPMC11992897

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.