Lorazepam treatment may be linked to poorer outcomes for pancreatic cancer patients

Patients with pancreatic cancer who took the benzodiazepine lorazepam, commonly prescribed to treat anxiety during cancer treatment, had a shorter progression-free survival than patients who did not, according to results published in Clinical Cancer Research,

Feigin and colleagues first evaluated how many patients take benzodiazepines during cancer treatment. The researchers then examined the relationship between benzodiazepine use and survival in patients with pancreatic cancer. When they adjusted for age, race, sex, disease stage and progression, and treatments received, 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.

Reference: Lorazepam stimulates IL-6 production and is associated with poor survival outcomes in pancreatic cancer, Clinical Cancer Research, DOI 10.1158/1078-0432.CCR-23-0547