The drug donepezil, which was developed for Alzheimer disease, improves cognitive function, mood, and perceived quality of life when given for six months to patients who received radiation therapy for brain tumors, according to an article in the March 20 issue of the Journal of Clinical Oncology.

Edward G. Shaw, MD, lead author of the paper, said “For survivors of brain tumor radiation, symptoms of short-term memory loss and mood changes similar to those seen in Alzheimer’s disease, as well as fatigue, frequently occur, leading to poor quality of life.”

The prospective, open-label Phase II study enrolled 34 patients who received donepezil 5 mg daily for 6 weeks, then 10 mg daily for 18 weeks, followed by a washout period of 6 weeks. Outcomes were assessed at baseline, 12, 24 (end of treatment), and 30 weeks (end of wash-out). A total of 24 patients (mean age, 45 years) remained on study for 24 weeks and completed all outcome assessments. All patients had a primary brain tumor, mostly low-grade glioma.

Scores significantly improved between baseline and week 24 on measures of attention/concentration, verbal memory, and figural memory; there was also a trend for verbal fluency. Confused mood also improved from baseline to 24 weeks, and there was a positive trend for fatigue and anger. Health-related quality of life improved significantly from baseline to 24 weeks, particularly for brain-specific concerns.

Because cognitive function, mood, and health-related quality of life all significantly improved following a 24-week course of donepezil and toxicity was minimal, a double-blind, placebo-controlled, phase III trial is planned.

The researchers decided to try donepezil after observing that radiation-induced brain injury resembles Alzheimer’s disease and other forms of dementia not only in the clinical symptoms but also in what is seen with brain imaging, particularly with magnetic resonance imaging and positron emission tomography.