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Corticosteroid switch in heavily pre-treated castration-resistant prostate cancer patients progressed on abiraterone acetate plus prednisone

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Summary

The aim of this retrospective study is to evaluate the activity and safety of a steroidal switch from prednisone to dexamethasone in patients with advanced, heavily pre-treated, castration-resistant prostate cancer (CRPC) who progressed on abiraterone acetate. Treatment consisted of oral daily abiraterone plus dexamethasone (0.5 mg once daily) administered until disease progression or unacceptable toxicity. Thirty-six patients were evaluated: all men underwent a prior treatment with enzalutamide. A PSA decrease ≥50% was observed in 11% of patients; median progression-free survival was 10.8 weeks (95% CI: 9.2–16), and median survival was 17.6 weeks (95% CI: 15.8–28.8). Better efficacy and survival were observed in the subgroup of patients treated with abiraterone acetate prior for a period >3 months; treatment was well tolerated, and no grade 3–4 toxicities were observed. Our findings did not suggest the use of steroid switch in all CRPC who were heavily pre-treated. However, the switch could be an option for patients who responded well to prior abiraterone acetate treatment.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Onco-Hematology, IRCCS-CROB, Referral Cancer Center of Basilicata, via Padre Pio 1, 85028 Rionero, Vulture, PZ, Italy

    Giandomenico Roviello, Raffaele Conca, Maria Grazia Rodriquenz & Michele Aieta

  2. Department of Medicine, Surgery and Neurosciences, Medical Oncology Unit, University of Siena, Viale Bracci - Policlinico “Le Scotte”, 53100, Siena, Italy

    Roberto Petrioli

  3. Radiotherapy Department, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy

    Alberto Bonetta

Authors
  1. Giandomenico Roviello
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  2. Roberto Petrioli
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  3. Alberto Bonetta
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  4. Raffaele Conca
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  5. Maria Grazia Rodriquenz
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  6. Michele Aieta
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Correspondence to Giandomenico Roviello.

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Conflict of Interest

Roviello G declares that he has no conflicts of interest. Petrioli R declares that he has no conflicts of interest. Bonetta A declares that he has no conflicts of interest. Conca R declares that he has no conflicts of interest. Rosellini P declares that she has no conflicts of interest. Aieta M declares that he has no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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When possible, informed consent was obtained from all individual participants included in the study.

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Roviello, G., Petrioli, R., Bonetta, A. et al. Corticosteroid switch in heavily pre-treated castration-resistant prostate cancer patients progressed on abiraterone acetate plus prednisone. Invest New Drugs 36, 1110–1115 (2018). https://doi.org/10.1007/s10637-018-0685-7

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  • DOI: https://doi.org/10.1007/s10637-018-0685-7

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