Clinical Experience of Steroid Switch from Prednisone to Dexamethasone in Patients with Metastatic Castration-Resistant Prostate Cancer Treated with Abiraterone Acetate

Urol Int. 2021;105(5-6):380-385. doi: 10.1159/000509882. Epub 2020 Aug 13.

Abstract

Objective: To evaluate the therapeutic efficacy of a steroid switch from prednisone to dexamethasone in Asians with metastatic castration-resistant prostate cancer (mCRPC) that progressed after docetaxel chemotherapy.

Methods: This study included postdocetaxel patients with mCRPC treated with abiraterone acetate combined with prednisone (AA + P) who had experienced prostate-specific antigen (PSA) progression. All patients underwent a steroid switch from prednisone (10 mg/day) to dexamethasone (1 mg/day). The PSA level and clinical symptoms were recorded. Moreover, follow-up was conducted until patients were either lost to follow-up or death.

Results: This study included 11 patients from a single center in Taiwan. The median follow-up time starting from AA + P treatment was 19.47 months. Seven patients (63.64%) had >30% PSA decline, and 6 patients (54.55%) had >50% PSA decline. The median percentage of PSA decline was 83.6%. The median time until PSA progression after the steroid switch was 11.38 months. No adverse events greater than grade 3 were noted.

Conclusions: Steroid switching is a feasible and effective therapy in docetaxel-treated Asian patients with mCRPC.

Keywords: Abiraterone; Prostate cancer; Steroid; Switch.

MeSH terms

  • Abiraterone Acetate / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Dexamethasone / therapeutic use*
  • Drug Substitution*
  • Glucocorticoids / therapeutic use*
  • Humans
  • Male
  • Neoplasm Metastasis
  • Prednisone / therapeutic use*
  • Prostatic Neoplasms, Castration-Resistant / drug therapy*
  • Prostatic Neoplasms, Castration-Resistant / pathology
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Glucocorticoids
  • Dexamethasone
  • Abiraterone Acetate
  • Prednisone