title: [Corticotherapy in castration-resistant prostate cancer].
abstract: BACKGROUND
  Corticosteroids are commonly used in the treatment of prostate cancer resistant to castration (PCRC), partly due to the inhibitory effects on adrenal androgen production acting as a pituitary suppressant.
  
  
  METHODS
  A literature search was conducted in PubMed/MEDLINE database using the following key words: prostate cancer; castration resistance; metastasis; corticotherapy.
  
  
  RESULTS
  Corticosteroids exert direct anti-tumoral activities mediated by the glucocorticoids receptor and involving cellular/tissue functions as growth, apoptosis, inflammation, metastasis, differentiation and angiogenesis. As a pain relieving agents, corticosteroids significantly relieve PCRC clinical symptoms, especially those due to bone metastasis. In the comparative arm of phase II-III trials, corticosteroids administered daily produce a PSA decline. Among the adverse effects due to corticosteroids, bone loss and cardiovascular risk should be carefully monitored. In association with abiraterone acetate, corticosteroids increase overall survival in PCRC patients, and reduce the mineralocorticoid side effects of abiraterone.
  
  
  CONCLUSIONS
  Corticosteroids in monotherapy for PCRC have a limited efficacy. In association with abiraterone acetate it reduces the mineralocorticoid toxicity and enhances the androgenic suppression.
authors: Service d'urologie, CHU Angers, 4 rue Larrey, 49100 Angers, France.
authors: S
authors: S
authors: Lebdai
authors: J
authors: J
authors: Branchereau
authors: G
authors: G
authors: Robert
authors: A
authors: A
authors: De La Taille
authors: P
authors: P
authors: Bouchaert
mesh_terms: D000736:Androstenes; D000737:Androstenols / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017209:Apoptosis / Q000187:drug effects; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D008297:Male; D009389:Neovascularization, Pathologic / Q000188:drug therapy; D017430:Prostate-Specific Antigen / Q000187:drug effects*; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000473:pathology; D011965:Receptors, Glucocorticoid / Q000187:drug effects; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000736:Androstenes; D000737:Androstenols; D000970:Antineoplastic Agents; D005938:Glucocorticoids; D011965:Receptors, Glucocorticoid; D017430:Prostate-Specific Antigen; C089740:abiraterone
keywords: Cancer de la prostate; Castration resistance; Corticotherapy; Corticothérapie; Metastasis; Métastases; Prostate cancer; Résistance à la castration