Psychological Symptom Trajectories and Non–Small Cell Lung Cancer Survival: A Joint Model Analysis

Abstract

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Association of Allostatic Load With Overall Mortality Among Patients With Metastatic Non–Small Cell Lung Cancer

“… 5 Social determinants of health are multilevel factors such as socioeconomic and political policy contexts, socioeconomic position, psychosocial factors, behaviors, biological factors, and living and working conditions that predispose to disease and drive inequities in clinical outcomes. 6 For patients with lung cancer, adverse SDHs such as delay in surgical care, 7 being unmarried, 8 lower socioeconomic status, 9 and continuing depressive symptoms 10 have been associated with higher mortality. Nonetheless, biological correlates for adverse SDHs and their implications for mortality are unclear and less studied.…”

Functional Trajectories and Resilience Among Adults With Advanced Lung Cancer

“…Previous research has revealed that psychological symptoms are associated with worse overall survival among patients with advanced lung cancer, providing further rationale for interventions to reduce depressive/anxiety symptoms. 40 Future directions will investigate the directionality of longitudinal psychological symptoms and disability.…”

Depression in association with neutrophil-to-lymphocyte, platelet-to-lymphocyte, and advanced lung cancer inflammation index biomarkers predicting lung cancer survival

“…It is unknown if the depression/inflammation association would remain once cancer treatment begins. However, we have shown the trajectory of depression from diagnosis through two years (18 assessments) predicted NSCLC patients' survival (HR = 1.09, 95% CI = 1.03-1.15, p = .002), above and beyond baseline depression, sociodemographics, smoking status, cell type, and receipt of targeted treatments and immunotherapies [6]. Taken together, data support psychological, behavioral, and biologic toxicities of depression capable of influencing treatment response and/or survival.…”

“…A plausible interpretation of this data is a differential effect of depression severity which "adds" to patients' basal level of inflammation arising from other sources. This may be a contributing mechanism to the uniquely high rates of depression in found LC patients at diagnosis [5,7,8] and the toxicity of the depression trajectory thereafter predicting lower survival [6].…”

“…In the general case, depression assessed at diagnosis is prognostic for mortality in cancer patients [4], with the strongest effects found in lung cancer [5]. Moreover, the continuing trajectory of depressive symptoms-from diagnosis through two years-predicts overall NSCLC survival [6]. Discovery of such effects is made possible, unfortunately, because of the high incidence of depression in NSCLC patients.…”