Small University of Rochester Trial Finds Modest Cognitive Benefits From Exercise and Ibuprofen During Chemotherapy

A University of Rochester phase 2 trial found that a home exercise program produced the clearest improvements in attention and cognitive function among cancer patients experiencing cognitive problems during chemotherapy. The trial studied 86 adult cancer patients in New York. Their average age was 53 and nearly 89% were women.

Patients were randomly assigned to one of four groups: home exercise only, exercise plus ibuprofen, ibuprofen alone, or placebo alone. The ibuprofen dose used was 200 milligrams twice a day. The exercise program consisted of low to moderate-intensity activity including progressive walking and training with resistance bands.

The University of Rochester trial lasted six weeks. After six weeks, exercise was linked to the clearest improvements in attention and cognitive function according to input from family and friends. In the group combining exercise and placebo, participants showed better attention levels compared to those who took just a placebo.

Participants who took only ibuprofen showed greater cognitive improvements than the placebo group. No adverse side effects were reported during the University of Rochester trial. Up to 80% of people who receive chemo experience some degree of cognitive impairment, previous studies have shown.

Chemo brain, also called chemotherapy-related cognitive impairment or CRCI, can affect memory, concentration and multitasking ability. The findings from the University of Rochester trial were published in Cancer, the peer-reviewed journal of the American Cancer Society.

Fox News reported that the results suggest ibuprofen may provide some improvement in cognitive function, although the benefits appeared to be smaller and less consistent than those seen with exercise.

Michelle C. Janelsins, MPH, of the University of Rochester and the Wilmot Cancer Institute, said this is one of the first studies specifically designed to assess these interventions for cancer-related cognitive impairment during chemotherapy in patients with multiple diseases using both performance-based cognitive assessments and patient-reported outcomes.

"We are encouraged by the findings of this trial that suggest possible benefits of both interventions for some cognitive domains," Janelsins said.

The researchers noted limitations of the study including the small sample size and short duration. The effects in the University of Rochester trial were not consistent across every measure of cognitive function. As the majority of participants in the University of Rochester trial were women, the findings may not be generalized to broader populations.

Researchers are planning larger phase 3 trials to confirm whether ibuprofen and exercise can effectively improve chemo-related cognitive impairment. Michelle C. Janelsins said since we saw cognitive benefits in some domains and not others, we will also consider additional doses and longer durations in future research trials.

Investigators emphasized that patients should speak with their oncology team before starting ibuprofen or exercise interventions during chemotherapy.