Steroid Switch in Metastatic Prostate Cancer: Outcomes of PSA Responders Versus Nonresponders
Posted: Tuesday, January 26, 2021
In a retrospective analysis conducted by Cindy J. Hernandez, MD, of the Vanderbilt University Medical Center, Nashville, and colleagues, the steroid switch from prednisone to dexamethasone resulted in a prostate-specific antigen (PSA) response in more than half of men with metastatic castration-resistant prostate cancer whose disease progressed on abiraterone acetate. The findings were presented in the virtual edition of the 2020 Society of Urologic Oncology (SUO) Annual Meeting (Abstract 134).
“Abiraterone acetate with prednisone is a standard treatment for metastatic castration-resistant prostate cancer,” the investigators commented. “However, there is some evidence demonstrating a PSA response and improved progression‐free survival with dexamethasone compared with prednisolone.” In this trial, the investigators performed an electronic medical record review and analysis of 27 men with metastatic castration-resistant prostate cancer treated with abiraterone acetate and who underwent a steroid switch from prednisone to dexamethasone.
At a median follow-up of 23.2 months, 59.2% of patients experienced a decrease in PSA levels. In patients treated with abiraterone acetate and dexamethasone, the median time to PSA progression was 4.0 months; one patient had not experienced PSA progression at 24.1 months after the steroid switch. In all patients, the median duration of overall survival was 25.1 months. Age, race, body mass index, Charlson Comorbidity Index, and PSA level at the time of the steroid switch did not seem to differ between responders and nonresponders significantly. The duration of overall survival was longer in patients with a PSA response after the steroid switch than in those without (34.9 vs. 17.5 months; P = .011).
Disclosure: No information regarding conflicts of interest was provided.
