Relationship between anti-depressant use and lung cancer survival

Abstract

Objectives In recent years, the anti-cancer properties of several commonly used drugs have been explored, with drugs such as aspirin and beta-blockers associated with improved cancer outcomes. Previous preclinical work demonstrated that tricyclic anti-depressants have antitumor efficacy in lung cancer. Our goal was to examine the association between anti-depressant use and survival in lung cancer. Materials and Methods We examined the association between use of common anti-depressants and survival in 1,097 lung cancer patients from the NCI-Maryland lung cancer study. The types of anti-depressants included in the study were norepinephrine and dopamine reuptake inhibitors, serotonin reuptake inhibitors, selective serotonin reuptake inhibitors, non-selective serotonin reuptake inhibitors, and tricyclic anti-depressants. Anti-depressant use was extracted from the medical history section of a detailed interviewer-administered questionnaire. Specific use in the three months before a lung cancer diagnosis was determined. Cox portioned hazards modeling was used to estimate the association between anti-depressant use with lung cancer-specific death with adjustment for potential confounding co-factors. Results Anti-depressant use was associated with extended lung cancer-specific survival. In an analysis of specific classes of anti-depressant use, NDRIs and TCAs were associated with improved survival. Importantly, the extended survival associated with anti-depressants was maintained after adjustment for the clinical indications for these drugs, suggestive of a direct effect on lung cancer biology. Conclusions Considering the manageable and largely tolerable side effects of anti-depressants, and the low cost of these drugs, these results indicate that evaluation of anti-depressants as adjunct therapeutics with chemotherapy may have a translational effect for lung cancer patients.

Modeling germline mutations in pineoblastoma uncovers lysosome disruption-based therapy

“…Of note, meta-analysis of tricyclic antidepressant users found a significant reduction in incidence of glioma and colorectal cancer 65 . Moreover, for lung cancer, tricyclic antidepressants or antihistamines significantly improved survival 40,66 .…”

Kava and its Kavalactones Inhibit Norepinephrine-induced Intracellular Calcium Influx in Lung Cancer Cells

“…Mechanistically, perturbing intracellular calcium homeostasis by stress hormones via the activation of adrenergic signaling has been implicated in the onset and progression of lung cancer [9,28], which may account for the cancerpromoting effect of psychological stress. Consistent with these, retrospective studies have demonstrated a clinical association between calcium channel blocker usage and reduced cancer mortality, particularly lung cancer [6,29,30]. Therefore, kavaʼs antistress properties may contribute to its anti-cancer potential.…”

“…Psychological stress was also found to be a significant predictor of lung cancer mortality [5]. Furthermore, epidemiological studies indicated extended lung cancer survival associated with antidepressant use [6]. These observations overall suggest the potential causality link between psychological stress and lung cancer risk/outcome, which has not been extensively explored in lung cancer management.…”

Impact of tricyclic antidepressants, selective serotonin reuptake inhibitors, and other antidepressants on overall survival of patients with advanced lung cancer from 2004 to 2014: University of Cincinnati experience

“…Another study of the associated risk of lung cancer with long term use of SSRIs and TCAs documented a protective effect for SSRIs and a slightly increased risk with TCAs. 24 Other antidepressants such as duloxetine, trazodone, and mirtazapine also showed a trend towards improved OS. 25 However, no specific trials or reviews have analyzed the potential antineoplastic effects of these agents.…”

“…6 Non-small cell lung cancer (NSCLC) is the predominant lung cancer disease, but the effect of TCAs on NSCLC tumor cells is poorly studied. 7 SCLC is the more aggressive form with frequent early metastases, and the disease is usually asymptomatic until an advanced stage. 4 Although SCLC is a chemo-and radio-sensitive disease that usually responds to initial treatment, recurrence is very common, with only 6% of patients surviving 5 years from their initial diagnosis.…”