# Lorazepam and Survival in Asian Patients with Pancreatic Cancer: A Retrospective Cohort Study

## TL;DR

This study found that high-dose lorazepam use in Asian pancreatic cancer patients undergoing chemotherapy was linked to worse progression-free survival, but not overall survival.

## Contribution

The study is the first to report an association between high-dose lorazepam and reduced progression-free survival in Asian pancreatic cancer patients.

## Key findings

- High-dose lorazepam was associated with shorter progression-free survival (median 6 vs. 8 months).
- No significant difference in overall survival was observed between high- and low-dose groups.
- Higher cumulative lorazepam exposure correlated with worse progression-free survival outcomes.

## Abstract

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

Data were retrospectively reviewed from patients aged ≥ 18 years with pathologically confirmed pancreatic cancer who received palliative chemotherapy 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.

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 = 0.025]. However, there was no difference in OS between the two groups [median, 11 months (10–12) vs. 12 months (11–13), p = 0.465].

Higher cumulative lorazepam exposure was associated with shorter progression-free survival in Asian patients with pancreatic cancer treated with palliative chemotherapy.

The online version contains supplementary material available at 10.1007/s12029-026-01429-7.