[Corticotherapy in castration-resistant prostate cancer]

Area of Science:

• Oncology
• Endocrinology
• Pharmacology

Context:

• Prostate cancer resistant to castration (PCRC) is a significant clinical challenge.
• Corticosteroids are frequently employed in PCRC management due to their adrenal suppression effects.

Purpose:

• To review the role and efficacy of corticosteroids in treating castration-resistant prostate cancer.
• To evaluate the direct anti-tumoral activities and clinical benefits of corticosteroids in PCRC.

Summary:

• Corticosteroids exhibit direct anti-tumoral effects via the glucocorticoid receptor, influencing cancer cell growth, apoptosis, and angiogenesis.
• While offering limited efficacy as monotherapy for PCRC, corticosteroids provide significant pain relief, especially for bone metastases, and can induce PSA decline.
• Adverse effects such as bone loss and cardiovascular risk necessitate careful monitoring.

Impact:

• Corticosteroids, in combination with abiraterone acetate, improve overall survival in PCRC patients.
• This combination therapy also mitigates the mineralocorticoid side effects associated with abiraterone acetate.
• Corticosteroids enhance androgenic suppression when used with abiraterone acetate, improving treatment outcomes in PCRC.