387P Clinical trial enrollment is associated with longer survival time among metastatic lung cancer patients: A population-based California cohort

Methods: In a national, register-based study , we identified all patients with newly diagnosed lung cancer.Each patient was matched 1:4 with a comparison subject from the general population on age, sex, municipality, and marital status.Data on hospital diagnoses and redeemed antidepressant prescriptions were obtained from nationwide registries.Multivariable logistic regression was used to adjust for baseline differences.Results: The study included 73,930 patients with lung cancer (LC) and 293,892 matched comparison subjects.Antidepressant use was already higher among LC patients two years before diagnosis (12.7% vs. 9.9%, p<0.001) and increased markedly after (23.7% vs. 11.9%two years after, p<0.001).Among patients with no prior antidepressant use, 8.4% (first year) and 13.7% (second year) initiated treatment, compared to 1.9% and 3.4% of controls, respectively (p<0.001).The risk of initiating antidepressant treatment remained significant after adjusting for educational level and comorbidity (Adjusted OR 4.9; 95% CI 4.7-5.2).Conclusions: Antidepressant use is widespread among lung cancer patients.It is frequently used before diagnosis and increases significantly after.The difference compared to the general population was most pronounced in patients with no prior antidepressant use.The findings highlight the need for systematic psychosocial assessment and integrated mental health support throughout the entire patient journey.