Veterans Affairs

Cotinine treatment for chemotherapy side effects

The cognitive deficits and mood changes associated with cancer-brain may be ameliorated with this new drug

Medical & Biotechnology

Candice Adams reacts to the effects of chemotherapy treatment at Walter Reed National Military Hospital. Adams was diagnosed with breast cancer at age 29. Russ Scalf/Air Force.

The Department of Veterans Affairs has invented a novel therapy for patients undergoing chemotherapy. The VA is seeking a health care company to develop it into an available treatment.

Chemotherapy is often used to treat cancer patients but the negative side effects are severe. Patients treated with chemotherapy are at an increased risk of altered brain structure and function, cerebral hyporesponsiveness and cognitive impairment upwards of 10 years post-treatment.

Clinical studies indicate that up to 70 percent of cancer patients who received chemotherapy experience cognitive impairment, fatigue, anxiety, and depression. This impairment, commonly named chemobrain, can affect working memory, attention, processing speed, concentration, and executive functions. Currently, there is no therapeutic agent to diminish cognitive impairment, anxiety, and depression after chemotherapy.

In response, VA researchers have developed a therapeutic for increasing neurogenesis in chemotherapy patients. This includes treating stress-induced neurogenesis deficits, increasing neurogenesis gene expression, and increasing neuronal cell formation. The treatment also addresses the neuropsychological side effects of chemotherapy, such as cognitive impairment and depressive-like behavior induced by chemotherapy.

The treatment uses cotinine, an alkaloid found in tobacco leaves as the main metabolite of nicotine. Cotinine has been studied as a treatment for depression, PTSD, schizophrenia, Alzheimer’s and Parkinson’s diseases.

This approach shows promise for the first time in treating, inhibiting and preventing chemotherapy-induced cognitive dysfunction, stress-related neurogenesis deficiency; chemotherapy-induced memory loss, depression and weight loss; and inducing neurogenesis gene expression. It is proposed that the treatment could be used prior to chemotherapy or prior to onset of chemotherapy-induced memory loss or depression.

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