Abstract | BACKGROUND: METHODS: We performed a ' steroid switch' in patients with CRPC at PSA progression on abiraterone and prednisolone. Patients were monitored for secondary declines in PSA, radiological tumour regression and toxicity. RESULTS: A retrospective analysis of 30 CRPC patients who underwent a steroid switch from prednisolone to dexamethasone while on abiraterone was performed. A total of six patients (20%) had a ⩾50% PSA decline that was confirmed by a second PSA level at least 3 weeks later. In all, 11 patients (39.2%) had a confirmed ⩾30% PSA decline. Median time to PSA progression on abiraterone and dexamethasone was 11.7 weeks (95% CI: 8.6-14.8 weeks) in the whole cohort and 27.6 weeks (95% CI: 14.5-40.7 weeks) in patients who achieved a confirmed 50% PSA decline. Nine patients had RECIST evaluable disease: two of these patients had RECIST partial response, six patients had stable disease and one patient had progressive disease at the first imaging assessment. Treatment was well tolerated, with no grade 3 and grade 4 adverse events. One patient had to be reverted to prednisolone because of grade 2 hypotension. CONCLUSIONS: Durable PSA responses occur in up to 40% of patients following a ' steroid switch' for PSA progression on abiraterone and prednisone. Studies are ongoing to elucidate the mechanisms underlying this response.
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Authors | D Lorente, A Omlin, R Ferraldeschi, C Pezaro, R Perez, J Mateo, A Altavilla, Z Zafeirou, N Tunariu, C Parker, D Dearnaley, S Gillessen, J de Bono, G Attard |
Journal | British journal of cancer
(Br J Cancer)
Vol. 111
Issue 12
Pg. 2248-53
(Dec 09 2014)
ISSN: 1532-1827 [Electronic] England |
PMID | 25314055
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Androstenes
- Anti-Inflammatory Agents
- Dexamethasone
- abiraterone
- Prednisone
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Topics |
- Aged
- Aged, 80 and over
- Androstenes
(therapeutic use)
- Anti-Inflammatory Agents
(therapeutic use)
- Dexamethasone
(therapeutic use)
- Humans
- Male
- Middle Aged
- Prednisone
(therapeutic use)
- Prostatic Neoplasms, Castration-Resistant
(drug therapy, pathology)
- Retrospective Studies
- Treatment Outcome
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