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Despite association, treatment of depression did not alter survival in metastatic lung cancer
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Despite the fact that depression in patients with metastatic lung cancer predicted worse survival, the employment of early palliative care to treat depression did not improve survival benefit, according to study results.
Previous research has shown that the use of early palliative care in patients with metastatic non–small cell lung cancer improved survival. In this study, the researchers sought to discover if this improvement was due to improving depression scores.
“Depression, which is treatable, may represent a target to improve both quality of life and survival in this population with a heavy symptom burden and poor prognosis,” the researchers wrote.
The study included 151 patients with newly diagnosed NSCLC. Patients were randomly assigned to treatment with early palliative care plus standard oncology care or standard oncology care alone. Patients were assessed for depression at baseline and at 12 weeks. Depression response was considered a 50% or greater improvement in Patient Health Questionnaire-9.
Overall, 21 of the 151 patients were identified as having major depression syndrome. Those patients assigned to early palliative care saw greater improvements in their depression scores at 12 weeks than those assigned standard care (P<.001). In addition, those assigned to early palliative care had greater rates of depression response at 12 weeks (42.9% vs. 0%; P=.04). There was no difference in the use of new antidepressants or mental health visits between the two groups.
Despite this improvement, changes in Patient Health Questionnaire-9 were not associated with a subsequent improvement in survival.
“Although survival might be considered the ultimate endpoint in oncology, depression is a disabling illness associated with suffering and poor quality of life that warrants intervention regardless of the potential impact on survival,” the researchers wrote. “EPC might represent another option for its treatment.”
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