Paroxetine for the Prevention of Depression Induced by High-Dose Interferon Alfa

Musselman, Dominique L.; Lawson, David H.; Gumnick, Jane F.; Manatunga, Amita K.; Penna, Suzanne; Goodkin, R.S.; Greiner, K.; Nemeroff, Charles B.; Miller, Andrew H.

doi:10.1056/nejm200103293441303

Cited by 1,012 publications

(625 citation statements)

References 23 publications

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“…Selective serotonin reuptake inhibitors (SSRI) have been reported to improve depression in advanced cancer (Holland et al, 1998), and in melanoma treated with interferon a (Musselman et al, 2001) since the latter also upregulates IDO (Taylor and Feng, 1991). However, these SSRI antidepressant effects might not depend on IDO-mediated serum tryptophan reduction, and studies of the effect of IDO inhibitors (Yuan et al, 1998) on cancer-related QoL deterioration would be needed to confirm the mechanism suggested by the present findings.…”

Section: Discussionmentioning

confidence: 62%

Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer

et al. 2002

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Cancer-related indoleamine (2,3)-dioxygenase up-regulation by interferon-g might influence quality of life by depleting serum tryptophan. We correlated serum tryptophan levels with immune activation and quality of life in patients with colorectal liver metastases. Venous blood was sampled from patients with primary colorectal cancer and from patients with metachronous colorectal liver metastases who completed quality of life and psychological questionnaires. Serum tryptophan, kynurenine, neopterin, interleukin 2 soluble receptor a (IL-2 sRa), soluble tumour necrosis factor receptor I (sTNF RI), interleukin 6, and C-reactive protein were measured. Liver metastasis volume was estimated by computerised tomography, and survival from blood sampling was noted. Sixty-six patients with colorectal cancer were studied (39 males; median age 66 years) of whom 25 had colorectal liver metastases only (17 males; median age 62 years; median liver metastasis volume 208 ml; median survival 234 days). Reduced serum tryptophan was significantly associated with Rotterdam Symptom Checklist physical symptom (r=70.51, P=0.01) and Sickness Impact Profile (r=70.42, P=0.04) scores, and correlated with increased serum neopterin (r=70.36, P=0.003), IL-2 sRa (r=70.51, P=0.01) and sTNF RI (r=70.45, P=0.02) levels. Stepwise regression analyses suggested that serum tryptophan was an independent predictor of Rotterdam Symptom Checklist physical symptom (regression coefficient 720.78, P=0.01) and Sickness Impact Profile (regression coefficient 7109.09, P=0.04) scores. The results supported a role for interferon-g-mediated serum tryptophan decrease in cancer-induced quality of life deterioration.

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Section: Discussionmentioning

confidence: 62%

Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer

et al. 2002

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“…This observation is consistent with other reports that the length of treatment, dose, and route of administration appear to be key factors related to the development of neurotoxicity (Meyers, 1997). Although these symptoms may persist for a small subgroup, most can be successfully palliated with prophylactic or symptomatic antidepressant therapy for neurobehavioural symptoms (Musselman et al, 2001), stimulant therapy for fatigue and neurobehavioural slowing, and opiate antagonist therapy for cognitive disorders (Valentine et al, 1998).…”

Section: Bioimmunotherapymentioning

confidence: 99%

Neuropsychological dysfunction associated with cancer and cancer therapies: a conceptual review of an emerging target

2004

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“…68 In a double-blind, randomized phase II trial of 40 patients undergoing interferon-α2b treatment for melanoma, the selective 5-hydroxytryptamine reuptake inhibitor paroxetine significantly decreased depression and increased the likelihood that patients completed the course of treatment as compared to patients receiving placebo. 69 The panel considers there to be level B data supporting prophylactic anti-depressant use.…”

Section: Literature Review and Analysismentioning

confidence: 99%

The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma

et al. 2013

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| Immunotherapy is associated with durable clinical benefit in patients with melanoma. The goal of this article is to provide evidence-based consensus recommendations for the use of immunotherapy in the clinical management of patients with high-risk and advanced-stage melanoma in the USA. To achieve this goal, the Society for Immunotherapy of Cancer sponsored a panel of melanoma experts-including physicians, nurses, and patient advocates-to develop a consensus for the clinical application of tumour immunotherapy for patients with melanoma. The Institute of Medicine clinical practice guidelines were used as a basis for this consensus development. A systematic literature search was performed for high-impact studies in English between 1992 and 2012 and was supplemented as appropriate by the panel. This consensus report focuses on issues related to patient selection, toxicity management, clinical end points and sequencing or combination of therapy. The literature review and consensus panel voting and discussion were used to generate recommendations for the use of immunotherapy in patients with melanoma, and to assess and rate the strength of the supporting evidence. From the peer-reviewed literature the consensus panel identified a role for interferon-α2b, pegylated-interferon-α2b, interleukin-2 (IL-2) and ipilimumab in the clinical management of melanoma. Expert recommendations for how to incorporate these agents into the therapeutic approach to melanoma are provided in this consensus statement. Tumour immunotherapy is a useful therapeutic strategy in the management of patients with melanoma and evidence-based consensus recommendations for clinical integration are provided and will be updated as warranted.

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Paroxetine for the Prevention of Depression Induced by High-Dose Interferon Alfa

Abstract: In patients with malignant melanoma, pretreatment with paroxetine appears to be an effective strategy for minimizing depression induced by interferon alfa.

Cited by 1,012 publications

References 23 publications

Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer

Serum tryptophan decrease correlates with immune activation and impaired quality of life in colorectal cancer

Neuropsychological dysfunction associated with cancer and cancer therapies: a conceptual review of an emerging target

The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma

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