Although the VEGFR TKI patients showed more cognitive Rucaparib PARP impair ments on the domain Executive Functions, both patient groups reported equal levels of psychological and somatic complaints on the self report questionnaires. Moreover, the non significant, yet slightly higher scores on depres sive symptoms and fatigue of the VEGFR TKI patients do not explain the lower scores on the memory and executive functioning tests. That is, no differences were found between the patient groups and the healthy control group on attention and concentration tasks, which are typically susceptible Inhibitors,Modulators,Libraries for mood disturbances and fatigue. We did not observe any consistent correlations between self reported cognitive complaints and neuropsychological measures neither in patients, nor in healthy controls, as is observed in patients treated with chemo therapy.

We chose to perform a cross sectional study design, which is frequently used in neuropsychology, as this could give an indication if cognitive functioning was indeed decreased. Inhibitors,Modulators,Libraries Our study design included two relevant and well matched control groups and the results were not confounded by practice effects through repeated testing. Furthermore, the in vitro rodent data demonstrated that VEGF plays a role in cognitive functioning. The com plaints of VEGF TKI treated patients about cognitive functioning and the result of this study support the neces sity for a longitudinal study on cognitive functioning in these patients. We included both patients on sunitinib and sorafenib.

As both sunitinib and sorafenib inhibit the VEGFR2, and we presumed that the cognitive functioning would be influenced by blocking this pathway, there was no reason to exclude one of both angiogenesis inhibi tors. We did not perform a MRI of the brain before in clusion but Included patients did not have symptomatic brain metastases. Therefore, Inhibitors,Modulators,Libraries we may have missed asymp tomatically brain metastases, although there is Inhibitors,Modulators,Libraries no reason to expect that this was different between the two patient groups. In our study we explored factors possibly influencing cognitive functioning in cancer patients and specifically in patients during VEGFR TKI treatment. We demon strated that male patients on treatment with sunitinib or sorafenib had lower free testosterone levels compared to patient controls, possibly due to the treatment. However we observed no relation between Inhibitors,Modulators,Libraries these sex hormones and cognitive functioning. Previous studies correlating cognitive functioning with testosterone levels in hypo gonadal men and studies on androgen ablation therapy selleck chem ARQ197 have produced inconsistent results. In contrast to others, we found no correlation between serum IL 8 concentrations and objective or subjective cognitive functioning.