Short-term adverse events during corticosteroid use in advanced cancer: a retrospective pilot study

. Systemic corticosteroids are widely used in oncology and palliative care, but short-term adverse effects in patients with advanced cancer are poorly described.

. We aimed to describe the incidence, timing and clinical impact of adverse events (AEs) potentially associated with short-term corticosteroid exposure, in hospitalized patients with advanced cancer.

. We conducted a monocentric retrospective descriptive pilot study for hypothesis generation, based on medical chart review by a single investigator, in an oncology department of a secondary care hospital. The study period extended from 1 September 2022 to 28 February 2023. Based on a literature review, we defined 12 AEs considered potentially related to corticosteroids. For each event, we recorded the day of onset since corticosteroid initiation, the dose and cumulative dose at onset, clinical consequences and therapeutic responses, associations between AEs and patient characteristics, corticosteroid prescription patterns and interacting concomitant drugs. Adult patients (>18 years) with advanced incurable cancer, with or without ongoing disease-directed anticancer treatment, who started systemic corticosteroids during admission were included.

. Twenty-nine patients (mean age 68 ± 11 years) were included. Nineteen patients (65.5%) developed ≥1 AE (52 events). The most frequent AEs were hypertension (n=11 patients among 28 with monitoring), infections (12 events for 10 patients), hyperglycemia (n=7 among 14 with monitoring) and insomnia (n=6). Approximately half of all adverse events occurred within the first 10 days of treatment. Patients with recorded AEs had longer corticosteroid exposure and more frequent dose adjustments during hospitalization.

. In hospitalized patients with advanced cancer, adverse events potentially associated with short-term systemic corticosteroid exposure were frequently recorded, often early after treatment initiation. These exploratory findings support the relevance of existing recommandations for careful monitoring and regular reassessment of corticosteroid therapy and warrant furter investigation in larger prospective studies.