18th August 2023, Mumbai: Recent research has unveiled a concerning finding: pancreatic cancer patients who are prescribed lorazepam may experience shorter progression-free survival compared to those who do not take this benzodiazepine. This study sheds light on the potential effects of benzodiazepine use on the outcomes of cancer patients, specifically in relation to pancreatic cancer.
Lorazepam and Pancreatic Cancer Progression
Patients undergoing treatment for pancreatic cancer, a particularly aggressive form of the disease, were found to have varying progression-free survival rates based on their use of benzodiazepines. Lorazepam, commonly known as Ativan, was identified as a culprit in causing shorter progression-free survival among pancreatic cancer patients who took it to manage anxiety during their cancer treatment.
Study Findings Published in Clinical Cancer Research
The study’s findings were published in Clinical Cancer Research, a reputable journal affiliated with the American Association for Cancer Research (AACR). This research aimed to delve into the relationship between benzodiazepine use, particularly lorazepam and alprazolam, and the progression of pancreatic cancer.
Benzodiazepines and Their Role in Cancer Treatment
Benzodiazepines belong to a class of medications that can alleviate symptoms of seizures, sleeplessness, and anxiety by reducing central nervous system activity. These drugs are often prescribed to cancer patients to manage the distressing symptoms brought about by both the disease itself and the treatments. However, thorough research into the potential impact of benzodiazepine use on cancer outcomes has been lacking.
Investigating the Influence of Benzodiazepines on Tumor Growth
Dr. Michael Feigin, the senior author of the study and an associate professor of pharmacology and therapeutics at Roswell Park Comprehensive Cancer Centre, stated that while cancer therapies are usually associated with treatments like chemotherapy or immunotherapy, the use of palliative care drugs for anxiety and pain is also prevalent among cancer patients. The study aimed to understand how such drugs, including benzodiazepines, affect tumor growth.
Prevalence of Benzodiazepine Use in Cancer Treatment
The study began by evaluating the percentage of patients taking benzodiazepines during cancer treatment at Roswell Park. Among various cancer types, patients with pancreatic cancer had the highest rate of benzodiazepine use, at 40.6%. The research then delved into the relationship between benzodiazepine use and the survival rates of pancreatic cancer patients.
Benzodiazepine Use and Pancreatic Cancer Survival
Upon adjusting for several factors including age, race, sex, disease stage, progression, and treatments received, it was discovered that any benzodiazepine use was linked to a 30% lower risk of pancreatic cancer-related death. However, the study took a closer look at individual benzodiazepines and their specific effects on pancreatic cancer outcomes.
Lorazepam vs. Alprazolam: Contrasting Effects
The study observed stark differences in outcomes between two commonly used benzodiazepines, lorazepam and alprazolam. Patients taking alprazolam experienced significantly better progression-free survival rates, with a 62% lower risk of disease progression or death compared to non-users. Conversely, those who took lorazepam faced a 3.83-fold higher risk of disease progression or death.
Mechanistic Insights: Role of GPR68 and IL-6
Further investigations into the mechanisms behind these differences were conducted. The study found that lorazepam may activate a protein known as GPR68, which boosts the expression of the inflammatory cytokine IL-6 in the tumor microenvironment. This inflammatory response leads to increased tumor growth. Interestingly, only a specific class of benzodiazepines, n-unsubstituted benzodiazepines, including lorazepam, were found to activate GPR68.
Clinical Implications and Future Prospects
Dr. Feigin clarified that while the findings are compelling, it’s premature to recommend patients to switch medications. The study’s next step is to conduct a clinical trial to evaluate the effects of lorazepam and alprazolam on pancreatic cancer outcomes and the tumor microenvironment in humans. This research will provide valuable insights into the potential clinical implications of these findings.
The study’s findings highlight the intricate relationship between benzodiazepine use and the progression of pancreatic cancer. While benzodiazepines are commonly prescribed to manage symptoms in cancer patients, careful consideration is necessary regarding their potential impact on cancer outcomes. As ongoing research delves deeper into the mechanisms behind these effects, patients and healthcare professionals will gain a clearer understanding of how to best manage anxiety and pain in cancer treatment while ensuring optimal outcomes.
-by Kashvi Gala