• Researchers from NeuRA (Neuroscience Research Australia) have found a common and affordable blood pressure medication may help prevent cancer-related cognitive impairment.
• Up to 75 % of cancer patients report cognitive symptoms, including memory and learning difficulties.
• The study successfully used candesartan, an angiotensin II receptor blocker or ARB, as a preventative intervention in an animal study, with calls for further research. 

Researchers have found that repurposing a safe and affordable blood pressure medication may help prevent cancer-related cognitive impairment.

NeuRA (Neuroscience Research Australia) PhD candidate, Delyse McCaffrey, led the study ​‘Candesartan, an angiotensin receptor blocker, prevents cognitive impairment in female mice with mammary cancer’, which was published in Brain, Behavior and Immunity. She worked alongside her supervisors Dr Adam K. Walker and Professor Cynthia Shannon Weickert, and in collaboration with Professor Raymond Chan at Flinders University, and Professor Janette Vardy at the University of Sydney.

“Up to 75% of cancer patients report cognitive symptoms, with around 30% experiencing persistent deficits that interfere with daily functioning and quality of life,” Ms McCaffrey said.

“This can impact a person’s ability to think, learn, remember, or make decisions. Despite the profound economic and psychosocial burden, there are limited therapeutic options.

“This study gave us the first evidence that medications like candesartan may offer the potential for preventing cancer-related cognitive impairment when given prior to chemotherapy.”

Cancer-related cognitive impairment is associated with a combination of factors including neuroinflammation, oxidative stress, and blood-brain barrier dysfunction, with evidence suggesting dysregulation of the renin-angiotensin system (RAS) which modulates these processes.

“A key advantage of candesartan is its ability to cross the blood – brain barrier and modulate neurobiological processes linked to cognitive decline in cancer, making it an attractive candidate for repurposing to prevent cancer-related cognitive impairment,” Dr Walker said.

The study introduced candesartan as a preventative intervention, during an early pre-treatment phase of tumour development. It investigated the impact on spatial reference memory and object recognition tasks in a mouse model of breast cancer.

“Our findings show that candesartan successfully prevented mammary cancer-induced spatial memory impairment without negatively affecting primary cancer outcomes,” Ms McCaffrey said.

“This highlights a potential low-cost strategy to protect cognitive function before chemotherapy begins.

“Our results support further exploration of RAS-targeted approaches in clinical settings. Since our model focused on prevention, future preclinical studies should also examine whether candesartan can reverse established cognitive impairment. If successful, this could provide clinicians with a tool that not only prevents but also treats cancer-related cognitive decline.”

Flinders University Deputy Vice Chancellor, Professor Raymond Chan, was involved in the study and said that recent analyses of blood samples from patients receiving chemotherapy show clear RAS alterations across breast, gastrointestinal, gynaecological and lung cancers, with disruptions most pronounced in patients experiencing self-reported cognitive impairment.

“Given this, we wanted to investigate whether we could prevent cancer-induced cognitive deficits by repurposing an existing angiotensin receptor blocker, such as candesartan,” Prof Chan said.

“This made the team led by Dr Adam K. Walker the most appropriate experts to build our collaboration on.”

Professor Alexandre Chan, who is Professor of Clinical Pharmacy and expert in supportive care in cancer at the University of California, Irvine, highlighted the finding as ​“not only as an exciting advance as this can potentially be implemented in the clinic, but this is also a huge area of unmet need in cancer survivorship, as many long-term survivors are suffering from cancer-related cognitive impairment, and currently evidence-based pharmacological options to improve cognition in cancer survivors are very limited.”

The study is available here.