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William J. Gradishar, MD, FACP, FASCO


Trust Your Gut? Probiotic Supplementation and Cognition in Patients With Breast Cancer

By: Hope Craig, MSPH
Posted: Wednesday, March 16, 2022

In a randomized, double-blind, placebo-controlled trial, researchers in China investigated whether taking a probiotic supplement during chemotherapy could prevent chemotherapy-related cognitive impairment in patients with breast cancer. Published in the European Journal of Cancer, the report also assessed the underlying mechanism of the therapy in a preclinical setting.

Jianbin Tong, PhD, of Central South University, and colleagues focused on 159 patients with breast cancer between the ages of 20 and 60 who needed chemotherapy between 2018 and 2019. Participants were randomly assigned to receive either probiotics (0.84 g) or placebo during chemotherapy, taken as three capsules twice daily. The probiotic capsules contained Bifidobacterium longum, Lactobacillus acidophilus, and Enterococcus faecalis, whereas the placebo contained the same composition without the probiotics. Participants underwent neuropsychological battery tests, including for social anxiety disorder and symptoms of dementia, the day before the first cycle of chemotherapy and 21 days after the last cycle, and they were followed for 2.5 years.

Probiotics supplements significantly decreased the incidence of chemotherapy-related cognitive impairment by 46%, improved overall cognitive function, changed gut microbial composition, and modulated plasma metabolite changes. Significantly higher scores were observed in the probiotics group for mean instantaneous verbal memory, mean instantaneous visuospatial therapy, delayed verbal memory, and delayed visuospatial memory. In both patients and in the preclinical setting, the team also detected profiling changes of gut microbiota throughout chemotherapy; in fact, the probiotics were found to “normalize” the composition of patients’ gut microbiota compared with the placebo group and corrected chemotherapy-induced dysbiosis in rats.

“Our study can be considered as a ‘proof of concept’ one, and hence the effectiveness of this therapy during chemotherapy needs to be evaluated further in the future trial[s] with a large sample size before it can be introduced for routine clinical use,” the authors cautioned.

Disclosure: The study authors reported no conflicts of interest.

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