Abstract 4993: A longitudinal examination of nutritional-inflammatory biomarker associations with cancer related cognition, treatment side effects and quality of life in newly diagnosed older adults undergoing chemotherapy

Abstract Intro: Chemotherapy-induced cognitive impairment affects 16-75% of cancer patients with neither a clear understanding of the underlying causes nor assessment guidelines for intervention. A potential consideration may be found in nutritional-inflammatory biomarker ratio panels of neutrophil-albumin ratio (NPAR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR). These calculated proportions may be obtained from readily available and normally scheduled chemotherapy labs and have been implicated for their prognostic value in cancer treatment effectiveness and/or mortality risk with sensitivity to multiple cancer types and stages. However, the relationships between these and cognitive, chemotherapy related symptoms and quality of life (QOL) evaluations have not yet been explored. Methods: This study examined data from a RCT of 144 newly diagnosed adult participants (≥ 60 years of age) undergoing first-time chemotherapy recruited from community cancer centers in central and south Florida. Various cancer types and stages were included with treatment cycles of 1-6 timepoints captured. NPAR, NLR, MLR, and PLR were calculated and ran as continuous variables for nonparametric Friedman analysis of variance and Wilcoxon signed rank tests and categorized into three equal groups of low, medium, and high for Pearson chi-square analyses. Cognitive and symptom information were collected through Mini-Mental State Examination (MMSE), EORTC - Quality of Life (QLQ-C30), and Symptom Representation Questionnaire (SRQ) instruments. Results: NPAR, NLR, PLR, and MLR were significantly associated with MMSE scores (p <0.001). Substantial changes were identified in individuals with moderate dementia and normal cognition between baseline through final chemotherapy treatments. Cognitive and emotional assessment (EORTC-QLQ) revealed significant associations between NPAR, NLR, PLR, MLR and feeling tense (p < 0.01), difficulty remembering, depression, pain, nausea, and needing assistance with ADLs (p < 0.05). Significant treatment-related symptom associations with NPAR, NLR, PLR, MLR were identified in hair loss, numbness (p < 0.001), nausea (p < 0.01), drowsiness, lack of appetite, and hot flashes (p < 0.05). Discussion: Nutritional-inflammatory lab ratios of NPAR, NLR, PLR, and MLR were significantly associated with cognitive, side effects, and QOL indicators during chemotherapy treatments of newly diagnosed older adult cancer patients. These easily obtained lab calculations may provide prognostic value in assessing and intervening in high-risk individuals to mitigate treatment-related sequalae. Citation Format: Jennifer M. Crook, Michael Owings, Victoria Loerzel. A longitudinal examination of nutritional-inflammatory biomarker associations with cancer related cognition, treatment side effects and quality of life in newly diagnosed older adults undergoing chemotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4993.