Association of antidepressant drug use with outcome of patients with glioblastoma. Issue 7 (17th November 2022)

• Record Type: Journal Article
• Authors: Seliger, Corinna; Oppong, Felix Boakye; Lefranc, Florence; Chinot, Olivier; Stupp, Roger; Nabors, Burt; Gorlia, Thierry; Weller, Michael
• Is Part Of: International journal of cancer. Volume 152:Issue 7(2023)
• Page Start: 1348
• Page End: 1359
• Publication Date: 2022-11-17
• Subjects: antidepressant drugs -- glioblastoma -- survival; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.34344
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Depressive symptoms are common among patients with glioblastoma, but patients are often not treated with antidepressants. There is only limited evidence on the association of antidepressant drug use with survival in glioblastoma. We performed a pooled analysis of patients treated within the CENTRIC, CORE, AVAglio and ACT‐IV trials to explore the relation of antidepressant drug use with progression‐free (PFS) and overall survival (OS) at baseline, at the start of maintenance therapy and at the start of maintenance cycle 4. We further assessed the association of antidepressant drugs with seizure, cognition, fatigue and a diagnosis of depression. Among more than 1700 patients, we found no significant association between the use of antidepressants at baseline or at the start of maintenance therapy and PFS or OS. However, we found OS, but not PFS, to be significantly worse in patients using antidepressants at the start of maintenance cycle 4. After adjustment for antiepileptic drug use and despite showing a trend for increased risk, seizures were not significantly associated with antidepressant drug use, nor was there a change in mini mental state examination (MMSE) scores or fatigue by antidepressant drug use at baseline. However, there was a significant positive association between antidepressant use at the start of maintenance treatment and fatigue during maintenance treatment. The association of antidepressant use at the start of maintenance cycle 4 with inferior OS of glioblastoma patients requires independent confirmation and further study. Further prospective trials should evaluate efficacy, side effects and associations with outcome of antidepressants in glioblastoma. Abstract : What's new? Depressive symptoms are common yet often undertreated in patients with glioblastoma, in part due to limited evidence on the association of antidepressant drug use with survival. Among 1, 700 patients with glioblastoma derived from clinical trials, the authors found no significant association between progression‐free or overall survival and the use of antidepressant drugs at baseline or at the start of maintenance therapy. While overall survival was worse at the start of maintenance cycle 4 in patients using antidepressant drugs, progression‐free survival was not significantly changed. The findings suggest that antidepressants should not be withheld from patients with glioblastoma.