In a nutshell
This study examined whether switching steroid drugs during secondary hormone therapy with abiraterone (Zytiga) improves treatment response in progressing, advanced prostate cancer. Researchers concluded that a steroid switch can be effective in delaying disease progression in some men.
Some background
Abiraterone is a secondary hormone therapy that can be used to treat advanced prostate cancer no longer responding to standard hormone therapy (also known as castration-resistant prostate cancer or CRPC). Hormone therapy is often associated with significant side effects. Steroid drugs are usually given with hormone therapy to decrease side effects. Commonly prescribed steroid drugs include prednisone (Deltasone) and dexamethasone (Dexpak). Early results have suggested that switching steroid drugs during abiraterone treatment can improve treatment response.
Methods & findings
The aim of this study was to examine the benefit of a steroid switch during abiraterone treatment for CRPC.
The records of 30 men with CRPC progressing during treatment with abiraterone plus prednisone treatment were analyzed. All men underwent a steroid switch from prednisone to dexamethasone during hormone therapy with abiraterone. The steroid switch was maintained for an average of 20.6 weeks.
20% of men showed a treatment response (based on blood tests) of at least 50%. A further 39.2% of men showed a treatment response of at least 30%. The average time to disease progression after the steroid switch was 11.7 weeks. Among men who achieved a treatment response of 50% or more, the average time to disease progression was 27.6 weeks. 2 of 9 men who had undergone a CT scan showed a partial treatment response based on imaging tests.
No serious side effects were noted. One man switched back to prednisone due to high blood pressure. Mild high blood pressure was observed in 21% of men. 7.1% of men had low potassium levels.
The bottom line
Researchers concluded that a steroid switch during abiraterone treatment can delay disease progression in some men with progressing, advanced prostate cancer.
The fine print
Larger randomized trails are needed to confirm these preliminary reports.
Published By :
British Journal of Cancer
Date :
Oct 14, 2014
