Lorazepam treatment may be linked to worse outcomes for pancreatic cancer patients (Associative progression risk -68% (Xanax) vs. +383% (Ativan))

Medical Xpress / American Association for Cancer Research / Clinical Cancer Research ^ | Aug. 16, 2023 | Abigail Cornwell et al

[ConservativeMind]

Patients with pancreatic cancer who took the benzodiazepine lorazepam (Ativan), commonly prescribed to treat anxiety during cancer treatment, had a shorter progression-free survival than patients who did not, according to results published.

In contrast, patients who took the benzodiazepine alprazolam (Xanax) had a significantly longer progression-free survival than patients who did not.

The researchers examined the relationship between benzodiazepine use and survival in patients with pancreatic cancer. When adjusted, any benzodiazepine use was associated with a 30% lower risk of pancreatic cancer-related death.

However, when Feigin and colleagues studied the relationship between individual benzodiazepines and pancreatic cancer outcomes, they found stark differences. Apart from short-acting benzodiazepines used as part of surgical anesthesia, the two most commonly used benzodiazepines were lorazepam (40 patients) and alprazolam (27 patients). Patients who took alprazolam had a 62% lower risk of disease progression or death compared with those who did not take alprazolam (42 patients). Conversely, patients taking lorazepam had a 3.83-fold higher risk of disease progression or death than patients who did not take lorazepam (29 patients).

When the researchers investigated the associations between lorazepam and alprazolam use and patient outcomes in other cancer types, they found that alprazolam was rarely associated with significantly different outcomes. However, lorazepam use correlated with significantly worse overall survival in prostate, ovarian, head and neck, uterine, colon, and breast cancer, as well as melanoma, with effects ranging from a 25% increased risk to a 116% increased risk.

"We think the mechanism comes down to a difference in structure between different benzodiazepines," Feigin said. "Alprazolam has the opposite effect as lorazepam; it has no impact on GPR68, but it potently decreases IL-6, and we think this decreases the inflammatory potential of these tumors."

[Ann Archy]

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