Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults

Haywood, Alison; Duc, Jacqueline; Good, Phillip; Khan, Sohil; Rickett, Kirsty; Vayne-Bossert, Petra; Hardy, Janet

doi:10.1002/14651858.cd012704

Cited by 7 publications

(8 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The efficacy of systematic steroids for the relief of cancerrelated breathlessness was investigated in a systematic review of two RCTs. 93 The first RCT, a placebocontrolled, double-blind pilot trial, tested the effect of dexamethasone among 41 patients with cancer on the reduction of breathlessness intensity 'now' as the primary outcome (NRS 0-10, subscale of the Edmonton Symptom Assessment System (ESAS), Modified Dyspnoea Borg Scale). 94 Between-group differences were not statistically significant, although there was a significant within-arm reduction of breathlessness intensity at day 4 in the dexamethasone group of 1.9 on ESAS (95% CI 3.3 to 0.5; p=0.01), whereas the placebo group showed a nonsignificant reduction of 0.7 (95% CI 2.1 to 0.6; p=0.38).…”

Section: Corticosteroidsmentioning

confidence: 99%

Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines

et al. 2020

View full text Add to dashboard Cite

Section: Corticosteroidsmentioning

confidence: 99%

Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines

et al. 2020

View full text Add to dashboard Cite

“…In cancer patients, steroids are largely used for treatment of cancer-related symptoms, such as dyspnea, fatigue, anorexia, and symptomatic brain metastasis [ 4 , 5 , 6 ]. Other conditions, not strictly related to cancer spread, may also require steroids prescription at the beginning or during the anticancer treatments: Exacerbations of chronic diseases (e.g., chronic obstructive pulmonary disease (COPD), rheumatic diseases, etc.)…”

Section: Introductionmentioning

confidence: 99%

Impact of Intercurrent Introduction of Steroids on Clinical Outcomes in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients under Immune-Checkpoint Inhibitors (ICI)

Giglio

Mezquita

Auclin

et al. 2020

Cancers

View full text Add to dashboard Cite

Background: Baseline steroids before ICI have been associated with poor outcomes, particularly when introduced due to cancer symptoms. Methods: Retrospective analysis of advanced NSCLC patients treated with ICI. We collected the use of intercurrent steroids (≥10 mg of prednisone-equivalent) within the first eight weeks of ICI. We correlated steroid use with patient outcomes according to the indications. Results: 413 patients received ICI, 299 were steroids-naïve at baseline. A total of 49 patients received intercurrent steroids (16%), of whom 38 for cancer-related symptoms and 11 for other indications, such as immune-related events. Overall, median (m) progression-free survival (PFS) was 1.9 months (mo.) [95% CI, 1.8-2.4] and overall survival (OS) 10 mo. [95% CI, 8.1–12.9]. Intercurrent steroids under ICI correlated with a shorter PFS/OS (1.3 and 2.3 mo. respectively, both p < 0.0001). Intercurrent steroids for cancer-related symptoms correlated with poorest mPFS [1.1 mo.; 95% CI, 0.9–1.5] and mOS [1.9 mo.; 95%CI, 1.5–2.4; p < 0.0001)]. No mOS and mPFS differences were found between cancer-unrelated-steroid group and no-steroid group. Steroid use for cancer-related symptoms was an independent prognostic factor for poor PFS [HR 2.64; 95% CI, 1.2–5.6] and OS [HR 4.53; 95% CI, 1.8–11.1], both p < 0.0001. Conclusion: Intercurrent steroids during ICI had no detrimental prognostic impact if the indication was unrelated to cancer symptoms.

show abstract

“…Dyspnoea affects up to 70% of cancer patients at the end of life and is often multifactorial in origin. There are currently several arguments in favour of the use of corticosteroids, depending on the origin of the dyspnoea, in particular in conditions that arise during tumour progression, such as bronchospasm, pleural effusion, or superior vena cava syndrome [ 35 , 36 , 37 ]. GCs have anti-inflammatory activities, and this may explain their ability to attenuate dyspnoea in view of the elevated inflammatory response in patients.…”

Section: Background: the Historical Role Of Glucocorticoids In Cancer...mentioning

confidence: 99%

Impact of Glucocorticoid Use in Oncology in the Immunotherapy Era

Kalfeist

Galland

Ledys

et al. 2022

Cells

View full text Add to dashboard Cite

Thanks to their anti-inflammatory, anti-oedema, and anti-allergy properties, glucocorticoids are among the most widely prescribed drugs in patients with cancer. The indications for glucocorticoid use are very wide and varied in the context of cancer and include the symptomatic management of cancer-related symptoms (compression, pain, oedema, altered general state) but also prevention or treatment of common side effects of anti-cancer therapies (nausea, allergies, etc.) or immune-related adverse events (irAE). In this review, we first give an overview of the different clinical situations where glucocorticoids are used in oncology. Next, we describe the current state of knowledge regarding the effects of these molecules on immune response, in particular anti-tumour response, and we summarize available data evaluating how these effects may interfere with the efficacy of immunotherapy using immune checkpoint inhibitors.

show abstract

Systemic corticosteroids for the management of cancer-related breathlessness (dyspnoea) in adults

Abstract: Issue 6. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

Cited by 7 publications

References 82 publications

Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines

Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines

Impact of Intercurrent Introduction of Steroids on Clinical Outcomes in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients under Immune-Checkpoint Inhibitors (ICI)

Impact of Glucocorticoid Use in Oncology in the Immunotherapy Era

Contact Info

Product

Resources

About