¹Yonsei University College of Medicine, Pathology, Seoul, Korea, Republic of, ²Seoul National University Hospital, Internal Medicine, Seoul, Korea, Republic of

Background: Lorazepam is frequently used in pancreatic cancer patients receiving chemotherapy for its antiemetic properties and to mitigate psychological distress. However, N-unsubstituted benzodiazepines like lorazepam may adversely impact pancreatic cancer progression by stimulating fibrosis and inflammatory signaling.

Aims & Objectives: This study aimed to retrospectively compare the survival rates of pancreatic cancer patients exposed to lorazepam with those who were not exposed in real-world clinical practice.

Method: Data were retrospectively reviewed from patients aged ≥18 years with pathologically confirmed pancreatic cancer who were treated at Seoul National University Hospital between January 2011 and January 2023. Patients were dichotomized based on lorazepam administration: those who received ≥ 15 mg (equivalent to ≥ 1 tablet daily for 30 days) were classified as the high-dose group, and those who received < 15 mg were classified as the low-dose group. The relationship between lorazepam exposure and progression-free survival (PFS), as well as overall survival (OS), was analyzed.

Results: Among pancreatic cancer patients undergoing palliative chemotherapy, PFS was worse in the high-dose lorazepam group compared to the low-dose group [median, 6 months (5–7) vs. 8 months (7–9), p = 0.021]. However, there was no difference in OS between the two groups [median, 11 months (10–12) vs. 12 months (11–13), p = 0.414].

Discussion & Conclusions: Lorazepam may influence the progression of pancreatic cancer in real-world settings.