Tumor Epidermal Growth Factor Receptor Genotype and Depression in Stage IV Non-Small Cell Lung Cancer

Pirl, William F.; Traeger, Lara; Greer, Joseph A.; Bemis, Heather; Gallagher, Emily R.; Lennes, Inga T.; Sequist, Lecia V.; Heist, Rebecca S.; Temel, Jennifer S.

doi:10.1634/theoncologist.2011-0116

Cited by 13 publications

(20 citation statements)

References 53 publications

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“…This study reveals depression heterogeneity among patients with NSCLC and specifically that those patients with EGFR mutations have less depression. These findings are consistent with other small studies but also demonstrate that this relationship is at least partially mediated by the presence of less inflammation . CRP, as an acute phase reactant, serves as a good marker of overall innate inflammation, which is the product of several proinflammatory cytokines.…”

Section: Discussionsupporting

confidence: 92%

“…In addition, patients were aware of their EGFR status, which may have psychological implications given the greater treatment options and prognosis for many patients with EGFR‐mutated NSCLC. Other studies evaluating depression in EGFR‐mutated NSCLC evaluated the depression status prior to obtaining the mutation status or starting treatment . The primary limitation of the study is the lack of understanding if the lower depression effect is due to the underlying biology of EGFR mutant NSCLC or the treatment.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are consistent with other small studies but also demonstrate that this relationship is at least partially mediated by the presence of less inflammation. [13][14][15] CRP, as an acute phase reactant, serves as a good marker of overall innate inflammation, which is the product of several proinflammatory cytokines. CRP, along with other proinflammatory cytokines, is a validated biomarker for depression.…”

Section: Discussionmentioning

confidence: 99%

“…EGFR‐mutated NSCLC was shown to be associated with less depression in two small‐scale observational studies . The findings were limited by incomplete EGFR reporting, small sample sizes, and the lack of a putative causative mechanism.…”

Section: Introductionmentioning

confidence: 98%

“…12 EGFR-mutated NSCLC was shown to be associated with less depression in two small-scale observational studies. 13,14 The findings were limited by incomplete EGFR reporting, small sample sizes, and the lack of a putative causative mechanism. A follow-up study found that lower depression in EGFR-mutated NSCLC was associated with elevated tumor necrosis factor-α (TNF-α), a proinflammatory cytokine.…”

Section: Introductionmentioning

confidence: 99%

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Depression and inflammation among epidermal growth factor receptor (EGFR) mutant nonsmall cell lung cancer patients

et al. 2019

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Objectives: Depression is highly prevalent in Non-Small Cell Lung cancer (NSCLC) and is associated with elevated inflammation. However, certain subtypes of driver mutation associated NSCLC such as Epidermal Growth Factor Receptor (EGFR) mutated NSCLC may be associated with less depression given the differences in their underlying biology and disease trajectories. Biological variables such as inflammation, measured by C-reactive protein (CRP), may provide insight into depression variability in EGFR mutant NSCLC. Methods: Patients with EGFR mutant and wild-type metastatic NSCLC were evaluated for depression using the Hospital Anxiety and Depression Scale (HADS) on a continuous scale and meeting depression screening criteria (HADS≥8). Inflammation was measured using CRP. A mediation model was created to understand how inflammation mediates EGFR wild-type associated depression. Results: One hundred out of 120 patients with NSCLC were recruited (83.3% response rate). The 20 participants with EGFR mutant NSCLC had less depression (HADS-D 3.0 versus 5.4) (p<.001), met depression screening criteria less often (p=.047), and exhibited less inflammation [CRP =0.23 mg/ml versus 2.71 mg/ml] (p<.001) in comparison with EGFR wild-type NSCLC. Multivariate linear regression model revealed that only CRP predicted depression (p=.015) while controlling for age and sex. Mediation analysis found that lower CRP partially mediated less depression in EGFR mutant NSCLC. Conclusion: EGFR mutant NSCLC is associated with less depression but the relationship is partially mediated by lower CRP-related inflammation, which is a stronger predictor of depression than EGFR status. Depression in lung cancer varies by subtype and is significantly related to inflammation.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Depression and inflammation among epidermal growth factor receptor (EGFR) mutant nonsmall cell lung cancer patients

et al. 2019

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Impact of molecular alterations on quality of life and prognostic understanding over time in patients with incurable lung cancer: a multicenter, longitudinal, prospective cohort study

Kuon

Blasi

Unsöld

et al. 2021

Support Care Cancer

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Purpose The purpose of this study is to investigate changes over time in quality of life (QoL) in incurable lung cancer patients and the impact of determinants like molecular alterations (MA). Methods In a prospective, longitudinal, multicentric study, we assessed QoL, symptom burden, psychological distress, unmet needs, and prognostic understanding of patients diagnosed with incurable lung cancer at the time of the diagnosis (T0) and after 3 (T1), 6 (T2) and 12 months (T3) using validated questionnaires like FACT-L, National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), PHQ-4, SCNS-SF-34, and SEIQoL. Results Two hundred seventeen patients were enrolled, 22 (10%) with reported MA. QoL scores improved over time, with a significant trend for DT, PHQ-4, and SCNS-SF-34. Significant determinants for stable or improving scores over time were survival > 6 months, performance status at the time of diagnosis, and presence of MA. Patients with MA showed better QoL scores (FACT-L at T1 104.4 vs 86.3; at T2 107.5 vs 90.0; at T3 100.9 vs 92.8) and lower psychological distress (NCCN DT at T1 3.3 vs 5; at T2 2.7 vs 4.5; at T3 3.7 vs 4.5; PHQ-4 at T1 2.3 vs 4.1; at T2 1.7 vs 3.6; at T3 2.2 vs 3.6), but also a worsening of the scores at 1 year and a higher percentage of inaccurate prognostic understanding (27 vs 17%) compared to patients without MA. Conclusion Patients with tumors harboring MA are at risk of QoL deterioration during the course of the disease. Physicians should adapt their communication strategies in order to maintain or improve QoL.

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New lung cancer treatments (immunotherapy and targeted therapies) and their associations with depression and other psychological side effects as compared to chemotherapy

McFarland

2019

General Hospital Psychiatry

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Objective-Lung cancer carries a high prevalence of distress, anxiety and depression. New treatments, targeted therapy and immunotherapy have changed the disease course for subsets of patients, but their psychological associations and possible mechanisms of action (e.g., inflammation and physical symptoms) are not well described. Method-Patients with metastatic lung cancer undergoing systemic treatment (n=109) were evaluated for distress and self-endorsed problems using the Distress Thermometer and Problem List and depression and anxiety using the Hospital Anxiety and Depression Scale. Demography, cancer-related information, and inflammation were evaluated for their associations with chemotherapy, targeted therapy, and immunotherapy. Results-Chemotherapies were given most often followed by immunotherapy and targeted therapies. Depression and anxiety were endorsed by 23.9%, respectively, and 41.1% had significant distress. Chemotherapy was associated with greater depression (p=.006) and inflammation (p<.001). Physical symptoms were the same among treatment types. Targeted therapy predicted for less depression (p=.028) and small cell lung cancer predicted for more depression (p=.041) when controlling for age and sex however these predictors where not significant when controlled for inflammation. Conclusion-New immunotherapy and targeted therapies are associated with less depression and inflammation among patients who are living longer while their physical symptoms are the same.

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Tumor Epidermal Growth Factor Receptor Genotype and Depression in Stage IV Non-Small Cell Lung Cancer

Cited by 13 publications

References 53 publications

Depression and inflammation among epidermal growth factor receptor (EGFR) mutant nonsmall cell lung cancer patients

Depression and inflammation among epidermal growth factor receptor (EGFR) mutant nonsmall cell lung cancer patients

Impact of molecular alterations on quality of life and prognostic understanding over time in patients with incurable lung cancer: a multicenter, longitudinal, prospective cohort study

New lung cancer treatments (immunotherapy and targeted therapies) and their associations with depression and other psychological side effects as compared to chemotherapy

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