Efficacy of low-dose dexamethasone in castration-refractory prostate cancer.
OBJECTIVE
To evaluate the prostate-specific antigen (PSA) response rate and duration of PSA response to dexamethasone in patients with castration-refractory prostate cancer (CRPC), as corticosteroids are frequently used as second-line hormonal treatment of CRPC and there is little published evidence concerning the efficacy of low-dose dexamethasone in this setting.


METHODS
In all, 102 patients with progressive CRPC received oral dexamethasone (0.5 mg daily) between January 2003 and October 2006. The median pretreatment PSA level was 83 ng/mL. The main endpoint was the PSA response rate according to the PSA Working Group criteria.


RESULTS
In all, 50 patients (49%) had a confirmed PSA response. The median (range) time to PSA progression for the entire cohort was 7.4 (1-28) months. In responders, the median duration of the PSA response was 11.6 (1-24) months.


CONCLUSIONS
Low-dose dexamethasone has significant activity in CRPC. Subject to validation with more clinically meaningful endpoints, dexamethasone could become the corticosteroid of choice in the management of CRPC, and its potential for use in combination with novel agents should be explored.
Venkitaraman
Ramachandran
R
Academic Urology Unit, Royal Marsden Hospital, Sutton, Surrey, UK.
Thomas
Karen
K
Huddart
Robert A
RA
Horwich
Alan
A
Dearnaley
David P
DP
Parker
Chris C
CC
D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015331:Cohort Studies; D003907:Dexamethasone / Q000627:therapeutic use*; D018450:Disease Progression; D004341:Drug Evaluation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D017430:Prostate-Specific Antigen / Q000187:drug effects*; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D003907:Dexamethasone; D017430:Prostate-Specific Antigen