Results from a placebo-controlled, randomised, double-blind, 3-arm clinical trial has shown that evening dosing of melatonin may prolong survival in Non-Small Cells lung cancer patients.
Eighty-four advanced (stage IIIB or IV) NSCLC patients receiving identical dosing of standard etoposide/cisplatin therapy, between the ages of 18 and 80 years.
The Study:
Patients were randomly assigned to 1 of 3 arms:
- Placebo at 8 a.m. and 8 p.m.
- 20 mg melatonin at 8 a.m. and placebo at 8 p.m.
- Placebo at 8 a.m. and 20 mg melatonin at 8 p.m.
Primary Outcome Measures
The main outcome measures were overall survival as well as sleep quality. Secondary outcomes measures were objective tumour response and quality of life.
Key Findings
This particular study focused on the importance of timing of melatonin and found a significant survival advantage for advanced lung cancer patients who supplement with melatonin in the evening. This benefit was not found in those who took melatonin in the morning. This study suggests that nighttime dosing of melatonin is a critical part of this hormone’s value.
Comments
Sleep is a wondrous thing for our bodies and brains. It is well-proven that proper sleep is essential for overall good health. Sleep also has numerous benefits for risk reduction of a number of cancer types, and plays a critical role in tolerance of chemotherapy and radiation treatment for our oncology patients.
Our bodies secrete anti-inflammatory cytokines during sleep.
Melatonin has a large impact specifically on nuclear factor kappa B (NF-κB), which is considered the emperor of the inflammatory cascade. This helps to explain why generalised inflammatory symptoms such as joint pain,2 swelling, fatigue, headache, anxiety/depression, or an upset digestive system are often milder upon waking in the morning when compared to bedtime. A recent study describes how shift workers can have increased levels of inflammation, which can lead to immune dysregulation and the many adverse consequences of shift work, cancer likely being one of them.
Melatonin is an anti-inflammatory compound and immune system–modulating hormone.5 It’s not surprising that melatonin can help normalise circadian rhythm as well as improve outcomes for patients with cancer.
In addition to improving quality of life through better sleep, melatonin impacts several intracellular signalling pathways that lead to down regulating growth and enhancing chemo sensitivity for non–small cell lung cancer patients receiving chemotherapy.
Melatonin is inexpensive and well-tolerated for the vast majority of patients.
Reference
Hrushesky WJM, Lis CG, Levin RD, et al. Daily evening melatonin prolongs survival among patients with advanced non-small-cell lung cancer. Biol Rhythm Res. 2021:1-15. DOI: 10.1080/09291016.2021.1899485.
