Outcomes from the use of computerized neurocognitive testing in a recurrent glioblastoma clinical trial

K M Field; E H Barnes; H W Sim; A K Nowak; J Simes; M A Rosenthal; H Wheeler; E J Hovey; L M Cher

doi:10.1016/j.jocn.2021.10.022

Outcomes from the use of computerized neurocognitive testing in a recurrent glioblastoma clinical trial

J Clin Neurosci. 2021 Dec:94:321-327. doi: 10.1016/j.jocn.2021.10.022. Epub 2021 Nov 12.

Authors

K M Field¹, E H Barnes², H W Sim², A K Nowak³, J Simes², M A Rosenthal⁴, H Wheeler⁵, E J Hovey⁶, L M Cher⁷

Affiliations

¹ Department of Medical Oncology, Royal Melbourne Hospital, Grattan St, Parkville, Vic 3050, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Grattan St, Parkville, Vic 3000, Australia. Electronic address: kathryn.field@petermac.org.
² National Health and Medical Research Council Clinical Trials Centre, University of Sydney, NSW 2006, Australia.
³ Department of Medical Oncology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, WA 6009, Australia; School of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
⁴ Department of Medical Oncology, Royal Melbourne Hospital, Grattan St, Parkville, Vic 3050, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, Grattan St, Parkville, Vic 3000, Australia.
⁵ Department of Medical Oncology, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia.
⁶ Department of Medical Oncology, Prince of Wales Hospital, Barker Street, Randwick, NSW 2031, Australia.
⁷ Department of Neurology, Austin Health, 145 Studley Road, Heidelberg, Vic 3084, Australia.

PMID: 34863458
DOI: 10.1016/j.jocn.2021.10.022

Abstract

Assessment of neurocognitive function (NCF) is important in brain tumor clinical trials, however there are varying methodologies available. We used the Cogstate computerized NCF testing battery and the mini-mental state examination (MMSE) to prospectively assess cognition in adult patients with recurrent glioblastoma (GBM) enrolled in the CABARET randomized phase II clinical trial of bevacizumab versus bevacizumab plus carboplatin chemotherapy. We determined completion rates; compared NCF results between trial arms; and assessed baseline NCF as a predictor of survival outcome. 93 of 103 eligible patients completed baseline Cogstate NCF testing. Completion rates were between 60 and 100% across each timepoint, and 38% at disease progression. There was no evidence of difference between arms in time to deterioration in NCF using either test. Prior to disease progression, deterioration on the Cogstate tests was substantially more common (90%) than deterioration on the MMSE (37%), and decline in the Cogstate composite score within the first 8 weeks was associated with shorter overall survival. This testing methodology may be useful when determining net clinical benefit for therapies in patients with recurrent GBM.

Keywords: Cogstate; Glioblastoma; Mini-mental state examination; Neurocognitive.

Publication types

Clinical Trial, Phase II
Randomized Controlled Trial

MeSH terms

Adult
Bevacizumab / therapeutic use
Brain Neoplasms* / complications
Brain Neoplasms* / diagnosis
Brain Neoplasms* / drug therapy
Carboplatin
Disease Progression
Glioblastoma* / diagnosis
Glioblastoma* / drug therapy
Humans

Substances

Bevacizumab
Carboplatin