Switching from prednisone to dexamethasone in metastatic castration resistant prostate cancer treated with abiraterone acetate in a multicenter study

Belenchón, I. Rivero; Calahorro, C. Muñoz; García, I. Osmán; Villar, P. Beardo; Ruíz, C.B. Congregado; Jiménez, Beatriz; Bartolo, John; Ibarguren, Roberto Llarena; Cameno, J. Extramina; López, R.A. Medina

doi:10.1016/s2666-1683(20)33180-3

Cited by 2 publications

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“…In this study, two factors favorable for both PFS and OS of corticosteroid switch were considered: lower PSA (≤ 20 ng/mL) at corticosteroid switch and longer mCRPC-free survival ( ≥ 18 months). Longer mCRPC-free survival, which is associated with longer PFS after corticosteroid switch, was shown by previous studies, as reported by Fenioux et al [ 12 ] and Rivero-Belenchón et al [ 16 ]. Furthermore, lower PSA at corticosteroid switch indicated longer PFS after corticosteroid switch [ 12 ].…”

Section: Discussionsupporting

confidence: 61%

“…Fenioux et al [ 12 ] reported that short PFS for A + P is a favorable factor predicting PFS after corticosteroid switch; however, Romero-Laorden et al [ 14 ] had contrasting results. Interestingly, PFS for A + P was not an independent factor predicting the effect of the corticosteroid switch in our study and the study reported by Rivero-Belenchón et al [ 16 ]. Further prospective studies with more enrolled patients are therefore needed to clarify the association between PFS for A + P and the efficacy of corticosteroid switch.…”

Section: Discussioncontrasting

confidence: 53%

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Corticosteroid switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients with biochemical progression on abiraterone acetate plus prednisone

Yang

Zhao

et al. 2021

BMC Cancer

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Background To assess the efficacies and potential predictors of a corticosteroid switch in metastatic castration-resistant prostate cancer (mCRPC) patients with biochemical progression on abiraterone acetate plus prednisone (A + P). Methods Patients with mCRPC treated between April 2016 and August 2020, who experienced biochemical progression on A + P and then switched to A plus dexamethasone (D), were retrospectively identified. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were PSA response, overall survival (OS), and safety. Results One hundred and thirty consecutive cases were enrolled. The median PFS and OS on A + D were 5.0 and 18.7 months, respectively. The best PSA decline of ≥50% (PSA50) and ≥ 30% (PSA30) were observed in 29.2 and 46.2% patients, respectively. Lower PSA at corticosteroid switch (≤ 20 ng/mL; median PFS, HR 0.63, p = 0.019; median OS, HR 0.38, p = 0.001) and longer mCRPC-free survival (≥ 18 months; median PFS, HR 0.61, p = 0.013; median OS, HR 0.51, p = 0.015) were identified as independent prognostic predictors associated with longer PFS and OS. A risk stratification tool was developed to select candidates for corticosteroid switch based on the independent prognostic predictors of PFS and OS. Conclusions A corticosteroid switch from prednisone to dexamethasone is effective for mCRPC which progressed on A + P treatment. Patients with lower PSA at corticosteroid switch and/or longer mCRPC-free survival may gain more benefits by the corticosteroid switch.

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Section: Discussionsupporting

confidence: 61%

Section: Discussioncontrasting

confidence: 53%

Corticosteroid switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients with biochemical progression on abiraterone acetate plus prednisone

Yang

Zhao

et al. 2021

BMC Cancer

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Prediction of PSA Response after Dexamethasone Switch during Abiraterone Acetate + Prednisolone Treatment of Metastatic Castration-Resistant Prostate Cancer Patients

Fekete,

Biró,

Gyergyay

et al. 2024

Cancers

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Background: The aim was to elaborate a predictive model to find responders for the corticosteroid switch (from prednisolone to dexamethasone) at the first prostate-specific antigen (PSA) progression (≥25% increase) during abiraterone acetate (AA) treatment of metastatic castration-resistant prostate cancer (mCRPC) patients. Methods: If PSA has decreased (≥25%) after switch, patients were considered responders. Logistic regression of 19 dichotomized parameters from routine laboratory and patients’ history was used to find the best model in a cohort of 67 patients. The model was validated in another cohort of 42 patients. Results: The model provided 92.5% and 90.5% accuracy in the testing and the validation cohorts, respectively. Overall the accuracy was 91.7%. The AUC of ROC curve was 0.92 (95% CI 0.85–0.96). After a median follow-up of 27.9 (26.3–84) months, the median AA+dexamethasone treatment duration (TD) in non-responders and responders was 4.7 (3.1–6.5) and 11.1 (8.5–12.9) months and the median overall survival (OS) was 23.2 (15.6–25.8) and 33.5 (26.1–38) months, respectively. Multivariate Cox regression revealed that responsiveness was an independent marker of TD and OS. Conclusions: A high accuracy model was developed for mCRPC patients in predicting cases which might benefit from the switch. For non-responders, induction of the next systemic treatment is indicated.

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Switching from prednisone to dexamethasone in metastatic castration resistant prostate cancer treated with abiraterone acetate in a multicenter study

Cited by 2 publications

References 0 publications

Corticosteroid switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients with biochemical progression on abiraterone acetate plus prednisone

Corticosteroid switch from prednisone to dexamethasone in metastatic castration-resistant prostate cancer patients with biochemical progression on abiraterone acetate plus prednisone

Prediction of PSA Response after Dexamethasone Switch during Abiraterone Acetate + Prednisolone Treatment of Metastatic Castration-Resistant Prostate Cancer Patients

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