{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T12:34:47Z","timestamp":1789734887475,"version":"4.0.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T00:00:00Z","timestamp":1741305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We investigated whether 1-year trajectories of cancer-related cognitive decline (CRCD) would be different in patients with chemotherapy combined with immune checkpoint inhibitors (chemoICI group) as compared with chemotherapy alone (chemo group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants scheduled with or without ICI were prospectively recruited from three academic hospitals and followed up for 1 year in four sessions. Subjective and objective CRCD were measured by Perceived Cognitive Impairment (PCI) and Montreal Cognitive Assessment (MoCA), respectively. Primary endpoints were MoCA and PCI score changes and minimal clinically important difference (MCID), which was defined as threshold for meaningful impairment events. Propensity score matching (PSM) was performed for group comparison using logistic regression with covariates including age, cancer stage, and baseline cognitive scores. Linear mixed models adjusted for repeated measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 1557 recruited patients PSM yielded 460 patient pairs (1:1). Mean PCI and MoCA scores of both groups reached MCID at 12-month session in both groups. In chemoICI, MoCA score changes were significantly lower in the 12-month session, and PCI score changes were lower in the 6, 9, and 12-month sessions than chemo (P&amp;lt;0.05). One-year meaningful impairment events risks were 0.44 and 0.56 in chemoICI, significantly higher than that of chemo (0.35 and 0.38, P&amp;lt;0.01). Significant differences were found in mean event-free survival time in patients with and without irAE in chemoICI subgroup analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that combining chemotherapy with ICIs may exacerbate CRCD compared to chemotherapy alone. However, reliance on screening tools and self-reported measures limits definitive conclusions. Future studies incorporating comprehensive neuropsychological assessments are warranted. This study underscores the importance of using comprehensive cognitive assessments in future research to better understand the impact of ICIs on cognitive function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2025.1540442","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T01:50:58Z","timestamp":1741312258000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Immune checkpoint inhibitors and cancer-related cognitive decline: a propensity score matched analysis in active chemotherapy patients"],"prefix":"10.3389","volume":"16","author":[{"given":"Guangmin","family":"Jian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiling","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongluo","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Si","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhoufang","family":"Chai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nianqi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youlong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cantong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiacai","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanqing","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiming","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zong-qing","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadian","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weizhi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2018.06.003","article-title":"An overview of cognitive impairment","volume":"34","author":"John","year":"2018","journal-title":"Clin Geriatr Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20272","article-title":"The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial","volume":"100","author":"Jeffrey","year":"2004","journal-title":"Cancer."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21258","article-title":"Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults","volume":"65","author":"Jeffrey","year":"2014","journal-title":"CA Cancer J Clin"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2012.43.0116","article-title":"Cancer- and cancer treatment-associated cognitive change: an update on the state of the science","volume":"30","author":"Tim","year":"2012","journal-title":"J Clin Oncol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.3390\/cancers15051615","article-title":"First-line immunotherapy with check-point inhibitors: prospective assessment of cognitive function","volume":"15","author":"Jamie","year":"2023","journal-title":"Cancers (Basel)."},{"key":"B6","doi-asserted-by":"publisher","first-page":"JCO2018786624","DOI":"10.1200\/jco.2018.78.6624","article-title":"Longitudinal trajectory and characterization of cancer-related cognitive impairment in a nationwide cohort study","volume":"36","author":"Michelle","year":"2018","journal-title":"J Clin Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3453","article-title":"A prospective study of cognitive function in men with non-seminomatous germ cell tumors","volume":"23","author":"Jeffrey","year":"2013","journal-title":"Psychooncology."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050817-084903","article-title":"Cognitive effects of cancer and cancer treatments","volume":"14","author":"Tim","year":"2018","journal-title":"Annu Rev Clin Psychol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-022-01318-4","article-title":"The effects of transcutaneous vagus nerve stimulation on functional connectivity within semantic and hippocampal networks in mild cognitive impairment","volume":"20","author":"Aidan","year":"2022","journal-title":"Neurotherapeutics."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2013.864260","article-title":"Prevalence, mechanisms, and management of cancer-related cognitive impairment","volume":"26","author":"Michelle","year":"2014","journal-title":"Int Rev Psychiatry"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3643","article-title":"Predictors of psychological functioning in children with cancer: disposition and cumulative life stressors","volume":"24","author":"Katianne M","year":"2014","journal-title":"Psychooncology."},{"key":"B12","doi-asserted-by":"publisher","first-page":"15347354231168624","DOI":"10.1177\/15347354231168624","article-title":"A randomized, controlled, parallel-group, trial on the long-term effects of melatonin on fatigue associated with breast cancer and its adjuvant treatments","volume":"22","author":"Abdolazim","year":"2023","journal-title":"Integr Cancer Ther"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/ptr.7180","article-title":"Amelioration of anxiety, depression, and chemotherapy related toxicity after crocin administration during chemotherapy of breast cancer: A double blind, randomized clinical trial","volume":"35","author":"Roham","year":"2021","journal-title":"Phytother Res"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-021-00617-2","article-title":"Cognitive adverse effects of chemotherapy and immunotherapy: are interventions within reach","volume":"18","author":"Sanne","year":"2022","journal-title":"Nat Rev Neurol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-019-05168-3","article-title":"Health-related quality of life, emotional burden, and neurocognitive function in the first generation of metastatic melanoma survivors treated with pembrolizumab: a longitudinal pilot study","volume":"28","author":"Rogiers","year":"2019","journal-title":"Support Care Cancer."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fmolb.2021.770413","article-title":"Long-term cognitive dysfunction in cancer survivors","volume":"8","author":"Zuzana","year":"2022","journal-title":"Front Mol Biosci"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(22)01654-3","article-title":"Adjuvant nivolumab plus ipilimumab or nivolumab alone versus placebo in patients with resected stage IV melanoma with no evidence of disease (IMMUNED): final results of a randomised, double-blind, phase 2 trial","volume":"400","author":"Elisabeth","year":"2022","journal-title":"Lancet."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703481","article-title":"Immune-related adverse events associated with immune checkpoint blockade","volume":"378","author":"Michael","year":"2018","journal-title":"N Engl J Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2020-001511","article-title":"Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immune effector cell-related adverse events","volume":"8","author":"Marcela","year":"2020","journal-title":"J Immunother Cancer."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.0423","article-title":"Estimation of the percentage of US patients with cancer who are eligible for immune checkpoint inhibitor drugs","volume":"3","author":"Alyson","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.1016\/j.annonc.2020.06.013","article-title":"Corrigendum to \u2018Prognostic and predictive value of the Immunoscore in stage III colon cancer patients treated with oxaliplatin in the prospective IDEA France PRODIGE-GERCOR cohort study\u2019: Annals of Oncology 2020; Volume 31: 921-929","volume":"31","author":"Pag s","year":"2020","journal-title":"Ann Oncol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"6191","DOI":"10.3390\/cancers13246191","article-title":"Cognitive decline following radiotherapy of head and neck cancer: systematic review and meta-analysis of MRI correlates","volume":"13","author":"Noor Shatirah","year":"2021","journal-title":"Cancers (Basel)."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2018.08.003","article-title":"Prospective comparison of the Montreal Cognitive Assessment (MoCA) and the Mini Mental State Examination (MMSE) in geriatric oncology","volume":"10","author":"Audrey","year":"2018","journal-title":"J Geriatr Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.5295","article-title":"Cognitive impairment in adolescent and young adult cancer patients: Pre-treatment findings of a longitudinal study","volume":"12","author":"Alexandre","year":"2022","journal-title":"Cancer Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1177\/0163278705275340","article-title":"Combining distribution- and anchor-based approaches to determine minimally important differences: the FACIT experience","volume":"28","author":"Kathleen","year":"2005","journal-title":"Eval Health Prof."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-2909","article-title":"The noninvestigational use of tyrosine kinase inhibitors in thyroid cancer: establishing a standard for patient safety and monitoring","volume":"98","author":"Aubrey","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2021.2049","article-title":"Association between neuronal autoantibodies and cognitive impairment in patients with lung cancer","volume":"7","author":"Frederik","year":"2021","journal-title":"JAMA Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4245","article-title":"Patient-oncologist alliance and psychosocial well-being in Chinese society strongly affect cancer management adherence with cancer of unknown primary","volume":"26","author":"Yifei","year":"2016","journal-title":"Psychooncology."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25126","article-title":"Health-related quality of life in patients with spinal metastases treated with or without spinal surgery: a prospective, longitudinal study","volume":"116","author":"Juan","year":"2010","journal-title":"Cancer."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1200\/jco.19.01866","article-title":"Patient-reported cognitive impairment among women with early breast cancer randomly assigned to endocrine therapy alone versus chemoendocrine therapy: results from TAILORx","volume":"38","author":"Lynne","year":"2020","journal-title":"J Clin Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2008.01138_10.x","article-title":"Sample size calculations in clinical research","volume":"64","author":"Glueck","year":"2008","journal-title":"Biometrics"},{"key":"B32","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1111\/j.1467-985X.2008.00538_2.x","article-title":"Sample size calculations in clinical research","volume":"171","author":"White","year":"2008","journal-title":"J Royal Stat Soc Series A: Stat Soc."},{"key":"B33","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1080\/00224065.2012.11917892","article-title":"Sample size calculations: practical methods for engineers and scientists","volume":"44","author":"Jensen, Willis","year":"2012","journal-title":"J Qual Technology."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697","article-title":"Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples","volume":"28","author":"Peter","year":"2009","journal-title":"Stat Med"},{"key":"B35","article-title":"Statistical methods for rates and proportions (Book)","volume":"46","author":"Ziegel","year":"2004","journal-title":"Technometrics"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1200\/jco.18.02363","article-title":"Why are objective and perceived cognitive function weakly correlated in patients with cancer","volume":"37","author":"Daniel","year":"2019","journal-title":"J Clin Oncol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1454","article-title":"The influence of priming and pre-existing knowledge of chemotherapy-associated cognitive complaints on the reporting of such complaints in breast cancer patients","volume":"18","author":"Sanne","year":"2008","journal-title":"Psychooncology."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djt073","article-title":"Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance","volume":"105","author":"Patricia","year":"2013","journal-title":"J Natl Cancer Inst"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdz410","article-title":"Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors","volume":"30","author":"Lange","year":"2019","journal-title":"Ann Oncol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-021-00598-6","article-title":"Health-related quality of life of patients with recurrent or metastatic cutaneous squamous cell carcinoma treated with pembrolizumab in KEYNOTE-629","volume":"11","author":"Brett","year":"2021","journal-title":"Dermatol Ther (Heidelb)."},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2016.04.009","article-title":"Prospective evaluation of the impact of antiangiogenic treatment on cognitive functions in metastatic renal cancer","volume":"2","author":"Florence","year":"2017","journal-title":"Eur Urol Focus."},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djz168","article-title":"Potential effect of immunotherapy agents on cognitive function in cancer patients","volume":"112","author":"Florence","year":"2019","journal-title":"J Natl Cancer Inst"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2011.36.8571","article-title":"Longitudinal assessment of chemotherapy-induced structural changes in cerebral white matter and its correlation with impaired cognitive functioning","volume":"30","author":"Sabine","year":"2011","journal-title":"J Clin Oncol"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x","article-title":"The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment","volume":"53","author":"Ziad","year":"2005","journal-title":"J Am Geriatr Soc"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4725","article-title":"Assessing cognitive function in patients treated with immune checkpoint inhibitors: A feasibility study","volume":"27","author":"Stefania","year":"2018","journal-title":"Psychooncology."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(10)70294-1","article-title":"International Cognition and Cancer Task Force recommendations to harmonise studies of cognitive function in patients with cancer","volume":"12","author":"Jeffrey","year":"2011","journal-title":"Lancet Oncol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1540442\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T01:51:01Z","timestamp":1741312261000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1540442\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,7]]},"references-count":46,"alternative-id":["10.3389\/fimmu.2025.1540442"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1540442","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,7]]},"article-number":"1540442"}}