Metabolomic profiling of salvia predicts risk of cognitive impairment in people with breast cancer — The Association Specialists
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Metabolomic profiling of salvia predicts risk of cognitive impairment in people with breast cancer (21175)

Courtney Cross 1 2 , Joanne Bowen 1 , Maya Davies 1 2 , Janet Coller 1 , Wayne Leifert 1 3 , Maxime Francois 3 , Rohit Joshi 1 4 , Beverly Fosh 5 , Bogda Koczwara 6 , Hannah Rose Wardill 1 2
  1. The University of Adelaide, Adelaide, SA, Australia
  2. South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
  3. Molecular Diagnostic Solutions Group, CSIRO Health & Biosecurity, Nutrition and Health Program, Adelaide, SA, Australia
  4. Northern Cancer Centre, Lyell McEwin Hospital, Adelaide, SA, Australia
  5. Adelaide Plastic Surgery, Adelaide, SA, Australia
  6. Flinders Medical Centre, Flinders University, Adelaise, SA, Australia

INTRODUCTION: Chemotherapy causes profound and often chronic cognitive impairment (CICI), consistently identified as a priority concern by cancer survivors. CICI is highly unpredictable even in homogeneous populations. This means, i) patients cannot be given accurate predictions about their risk of developing CICI, and ii) symptoms are managed reactively. Here, we tested a novel saliva-based profiling technique to predict patients at risk of CICI, to provide clarity to patients and care providers on individual treatment response and risks.

METHODS: Untargeted and targeted metabolomic analyses using GCMS were performed in N=65 pre-chemotherapy saliva samples of newly diagnosed patients with cancer. Metabolomic data was assessed using multivariate analysis software SIMCA and MetaboAnalyst to compare the saliva-metabolome of patient cohorts aggregated on diagnosis and, in patients with breast cancer, their development of CICI (defined by the Functional Assessment of Cancer Therapy – Cognitive Function (FACT-Cog)). Individual metabolites predictive of cognitive impairment were also identified by measuring the % area under the ROC curve.

RESULTS: Metabolomic signatures in pre-chemotherapy saliva accurately discriminated patients based on cancer type (R2Y=0.82) and, in people with breast cancer, those who did and did not develop cognitive impairment (ROC=0.86). Biomarker analysis identified two potential metabolites that independently predicted the risk of developing cognitive impairment: D-maltose (ROC=0.84) and salicylic acid (ROC=0.84).

CONCLUSIONS: “Saliva-omic” profiling presents as a minimally invasive and inexpensive tool to predict a patient’s risk of CICI. Translation of this knowledge would provide much needed clarity for patients and care providers, as well as precise and targeted supportive care.