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.

Keywords: antidepressants; lung cancer; survival.

Figure 1

Kaplan-Meier curves depicting the relationship between antidepressant use and lung cancer-specific survival. A) Overall antidepressant use and lung cancer-specific survival, B) NDRI sole use, and C) TCA sole use. NDRI denotes norepinephrine reuptake inhibitor, TCA denotes tricyclic antidepressant.

Figure 1

Kaplan-Meier curves depicting the relationship between antidepressant use and lung cancer-specific survival. A) Overall antidepressant use and lung cancer-specific survival, B) NDRI sole use, and C) TCA sole use. NDRI denotes norepinephrine reuptake inhibitor, TCA denotes tricyclic antidepressant.

Figure 1

Kaplan-Meier curves depicting the relationship between antidepressant use and lung cancer-specific survival. A) Overall antidepressant use and lung cancer-specific survival, B) NDRI sole use, and C) TCA sole use. NDRI denotes norepinephrine reuptake inhibitor, TCA denotes tricyclic antidepressant.