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Use of Dexamethasone Oral Solution in Patients Receiving Treatment for Breast Cancer

Posted: Monday, May 1, 2017

For patients receiving everolimus and exemestane therapy for breast cancer, the prophylactic use of a dexamethasone oral solution substantially reduced the incidence and severity of stomatitis, according to a study by Rugo et al in The Lancet Oncology. The investigators suggest this dexamethasone mouthwash could be a new standard of oral care for these patients.

A total of 92 women aged 18 years and older with a postmenopausal status who had histologically or cytologically confirmed metastatic hormone receptor–positive, HER2-negative breast cancer were enrolled on this U.S.-based, multicenter, single-arm phase II prevention study. By 8 weeks, the incidence of grade 2 or worse stomatitis was 2% (2 of the 85 evaluable patients, 95% confidence interval [CI]: 0.29–8.24), vs 33% (159 of 482 patients, 95% CI: 28.8–37.4) for the duration of the BOLERO-2 study.

Overall, about 90% of study patients had at least one adverse event, with the most reported grade 3 and 4 adverse events in the safety set being hyperglycemia (8%), rash (4%), and dyspnea (3%). A total of 12 of the 92 patients (13%) had adverse events suspected to be related to treatment, which led to discontinuation of everolimus and exemestane; the most common were rash, hyperglycemia, and stomatitis, which each affected 2% of patients.