Nicotinic treatment of post-chemotherapy subjective cognitive impairment: a pilot study

J Cancer Surviv. 2019 Oct;13(5):673-686. doi: 10.1007/s11764-019-00786-6. Epub 2019 Jul 23.


Purpose: Persistent chemotherapy-related cognitive impairment (pCRCI) is commonly reported following cancer treatment and negatively affects quality of life; however, there is currently no pharmacological treatment indicated for pCRCI. This pilot study obtained preliminary data regarding the use of transdermal nicotine patches as a therapeutic strategy for women with pCRCI to (1) reduce subjective cognitive complaints and (2) enhance objective cognitive performance in breast, colon, lymphoma, or ovarian cancer survivors with pCRCI.

Methods: Participants were randomized to either placebo (n = 11) or transdermal nicotine (n = 11) for 6 weeks, followed by 2 weeks of treatment withdrawal for a total of 8 weeks. Participants were assessed using both subjective and objective measures of cognitive functioning at five visits before, during, and after treatment.

Results: Over the course of the study, women in both groups improved substantially in severity of self-reported cognitive complaints measured by Functional Assessment of Cancer Therapy-Cognitive Function Perceived Cognitive Impairments regardless of treatment arm. Additionally, objective cognitive performance measures improved in both groups; however, there was no significant difference in improvement between groups.

Conclusions: Due to a large placebo response, we were unable to determine if a drug effect was present. However, we did observe substantial improvement in self-reported cognitive symptoms, likely resulting from factors related to participation in the trial rather than specific drug treatment effects.

Trial registration: The study was registered with (trial registration: NCT02312943).

Implications for cancer survivors: These results suggest that women with pCRCI can exhibit improvement in subjective cognition, with attention paid to symptoms and close follow-up over a short period of time.

Keywords: Breast cancer; Chemotherapy-related cognitive impairment; Clinical trial; Cognitive impairment; Survivorship.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cancer Survivors*
  • Cognition / drug effects
  • Cognitive Dysfunction / chemically induced*
  • Cognitive Dysfunction / drug therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / psychology
  • Nicotine / administration & dosage*
  • Nicotine / adverse effects
  • Pilot Projects
  • Quality of Life / psychology
  • Self Report
  • Survivors / psychology
  • Transdermal Patch


  • Nicotine