October 2023 | George M. Pikler, M.D., Ph.D., FACP

Lorazepam Affects Cancer Survival

It might matter which benzodiazepines (BZD) are prescribed to cancer patients to treat anxiety, insomnia, and chemotherapy-induced nausea. A research team at Roswell Park Comprehensive Cancer Center (1) investigated the association between BZDs and survival outcomes in early- and late-stage disease across multiple cancer types.

Their research with pancreatic cancer patients receiving chemotherapy found that among those whose disease did not get worse during the trial, the patients who took lorazepam (Ativan) did not live as long as those who were not on the medication. Alprazolam (Xanax) had the opposite effect: patients whose cancer didn’t worsen lived longer if they were taking the drug than did those who weren’t.

The researchers provide a potential mechanistic explanation for their clinical findings: lorazepam promotes desmoplasia (fibrosis and extracellular matrix protein deposition), inflammatory signaling, and ischemic necrosis in the pancreatic ductal adenocarcinoma tumor microenvironment. It also increases IL6 secretion by cancer-associated fibroblasts (CAFs). These phenotypes are associated with chemoresistance, subsequently decreasing pancreatic cancer patient survival.

Lorazepam is also associated with worse survival outcomes in several other cancer types, including ovarian, colon and breast cancers as well as melanoma.

(1) Clin Cancer Res (2023) 29 (18): 3793-3818