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Corticosteroid switch after progression on abiraterone acetate plus prednisone
Giandomenico Roviello1, Navid Sobhani2,3, Silvia Paola Corona2
1Department of Health Sciences, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy. giandomenicoroviello@hotmail.it.
International Journal of Clinical Oncology
|November 10, 2019
Summary
Switching steroids to dexamethasone may benefit prostate cancer patients progressing on abiraterone acetate plus prednisone. This steroid switch offers a viable option for select patients, improving treatment outcomes.
Area of Science:
- Oncology
- Pharmacology
- Clinical Medicine
Background:
- Abiraterone acetate plus prednisone is a standard treatment for metastatic castration-resistant prostate cancer.
- Evidence suggests a potential benefit of switching from prednisone to dexamethasone in patients who progress on abiraterone acetate plus prednisone or prednisolone.
Purpose of the Study:
- To review clinical studies on steroid switching in prostate cancer patients treated with abiraterone acetate.
- To examine potential mechanisms of action and patient selection criteria for this therapeutic strategy.
Main Methods:
- Systematic review of four clinical studies evaluating the steroid switch.
- Analysis of patient eligibility criteria and treatment outcomes.
Main Results:
- Key eligibility criteria for steroid switch include PSA progression without radiological/clinical progression, absence of high-grade CYP-17 inhibition adverse events, and unsuitability for chemotherapy or radium-223.
- Identified specific patient subgroups who may benefit from the steroid switch.
Conclusions:
- Steroid switch appears to be a promising option for selected patients with metastatic castration-resistant prostate cancer progressing on abiraterone acetate plus prednisone or prednisolone.
- Further large randomized prospective trials are needed to validate these findings and optimize patient selection.
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