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ASCO 2026 | Management of cancer-related cognitive impairment in patients

Filippos Koinis, MD, PhD, University of Thessaly, Larissa, Greece, comments on the importance of incorporating cognitive assessment into clinical practice for cancer-related cognitive impairment (CRCI), emphasizing the need for validation in larger multicenter trials before broader implementation. Physical exercise, cognitive exercise, improved sleep quality, and a balanced diet, such as a Mediterranean-style diet, all contribute in alleviating CRCI symptoms. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

Our study adds data into incorporating cognitive assessment into everyday clinical practice, but we have to be cautious. I think validation of our results in larger multicenter clinical trials is needed before recommending broader implementation into everyday clinical practice. And the second question, how should we intervene? Yes, this is an important question, and I have to be honest with our audience...

Our study adds data into incorporating cognitive assessment into everyday clinical practice, but we have to be cautious. I think validation of our results in larger multicenter clinical trials is needed before recommending broader implementation into everyday clinical practice. And the second question, how should we intervene? Yes, this is an important question, and I have to be honest with our audience. To the best of my knowledge, there is no drug that we can rely on in order to improve CRCI. So what tools do we have? We have physical exercise. We know that physical exercise reduces inflammatory cytokines. And when we contract our muscles, they release myokines that have beneficial effects on CRCI symptoms. Having said that, I think it is exciting to consider a combination of physical exercise and cognitive exercise, which may augment the effects of either strategy alone. Beyond that, we need to have better quality sleep. And to achieve this, I think we cannot rely on sleeping pills because we know that sleeping pills reduce the time we spend on REM sleep. And this REM sleep is the sleep stage that has to do a lot with memory consolidation. So again, treating depression, treating dementia, all of these disorders, as we said before, add to the emergence of CRCI. So I think that today I cannot emphasize enough the importance of physical exercise together with cognitive exercise. On a nutritional level, we should encourage our patients to have a better balance between omega-6 and omega-3 fatty acids and move on to what we call a Mediterranean style of diet, closer to that. So all of these factors can help our patients alleviate their symptoms of CRCI.

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