Purpose: The trial demonstrated strong efficacy in improving depression in patients with advanced cancer. Here we report secondary trial outcomes including changes in the Edmonton Symptom Assessment Scale-revised (ESAS-r), death anxiety (Death Anxiety and Distress Scale, DADDS), and quality of life (McGill Quality of Life, MQOL).
Sample: The study involved 20 patients with advanced cancer recruited from oncology clinics at the Princess Margaret Cancer Centre. Secondary outcomes were available for n=15 subjects.
Procedures: Participants received three flexible doses of intranasal (IN) ketamine (50–150 mg) over a one-week period. Paired t-tests were conducted to assess differences between baseline and primary end-point (Day 8), and Cohen’s d was used to evaluate effect size for each outcome. Qualitative feedback from participants confirm the reduction in death anxiety and improvement in well-being.
Results: IN ketamine significantly reduced ESAS-r physical symptoms (t(28) = 2.35, p = 0.013, Cohen’s d = 0.86) and emotional symptoms (t(28) = 2.39, p = 0.022, Cohen’s d = 0.88), as well as death anxiety (t(28) = 2.18, p = 0.019, Cohen’s d = 0.78). No significant change was observed in quality of life (MQOL, t(28) = 1.11, p = 0.277, Cohen’s d = 0.41), but the ESAS-r well-being item improved significantly (t(28) = 1.98, p = 0.029, Cohen’s d = 0.72).
Conclusion: IN ketamine was associated with reductions in physical symptoms, emotional distress, death anxiety and well-being at end of life. These findings suggest additional rapid benefits of treating depression with IN ketamine in patients with advanced cancer.