In a nutshell
This study examined the efficacy of including an anti-inflammatory hormone, prednisolone (Orapred), with the chemotherapy drug docetaxel (Taxotere) in the treatment of metastatic castration-resistant prostate cancer. The study concluded that prednisolone led to a decrease in specific adverse side effects of this type of chemotherapy, without affecting disease progression.
Some background
Metastatic castration-resistant prostate cancer (mCRPC) is a type of prostate cancer which has spread to other areas of the body and is resistant to androgen deprivation therapy (reduction of male hormones like testosterone which cause prostate cancer growth).The chemotherapy docetaxel is a first-line treatment for mCRPC. It is a cytotoxic drug, in that it can cause adverse (negative) side effects. These effects can include peripheral edema (swelling of the lower limbs), non-hematological toxicity (toxicity outside the blood and bone marrow) and febrile neutropenia (low amounts of white blood cells leading to fever). Low-dose glucocorticoids, such as prednisolone, are anti-inflammatory hormones which have been shown to have a positive effect in terms of pain relief and improvements to quality of life when coupled with certain chemotherapy drugs
Methods & findings
This study examined the effect of combining prednisolone with docetaxel on adverse effects and disease progression in patients with mCRPC.
343 patients were examined in this study. 109 patients received docetaxel only (DO) and 234 received docetaxel combined with prednisolone (DP). The patients underwent 7–8 cycles of treatment. Patients were monitored over the course of approximately 8 years.
Peripheral edema occurred in 32% of patients treated with DO and 15% of patients treated with DP. Non-hematological toxicity occurred in 56% of patients treated with DO and 43% of patients treated with DP. Febrile neutropenia was also experienced by more DO patients (25%) compared to DP patients (10%).
Overall survival (time from treatment until death from any cause) and progression-free survival (time from treatment until disease progression) were not affected by combining prednisolone with docetaxel
The bottom line
The study concluded that prednisolone was effective in improving the quality of life during docetaxel chemotherapy administration but had no effect on overall survival.
The fine print
The treatments were performed in two different hospitals with patients specific to each, thus there may be differences in local treatment strategies.
What’s next?
Discuss the use of low-dose glucocorticoids with your physician.
Published By :
Urologic oncology
Date :
Aug 05, 2015
