There are lots of news releases coming out from the ASCO meeting. Click here to see an example. As is often the case, some of the novel findings make people nervous or excited, depending on the context. In this example, Howie Scher, who is the leader of the clinical prostate cancer program at MSKI, did a post-hoc analysis of corticosteroid use (prednisone, dexamethasone, etc) in patients on a study of enzalutamide (Xtandi). It appears the patients on steroids did worse than those who were not on steroids. The problem with these kinds of headlines is that the situation/biology/patients are more complicated than the headlines. Often patients who are on steroids have worse disease (more pain, spinal cord metastases, etc.) and are just plain “sicker”. There are volumes of articles/literature suggesting patients may actually respond favorably to steroid use in many situations. We used daily low dose dexamethasone along with low dose cyclophosphamide in a trial that showed excellent psa responses, and in the 1990’s trials with some agents were found to be “positive” largely due to the inclusion of corticosteroids. So the timing and the context of steroid use can be very important in determining outcomes for prostate cancer patients.
In any case, the meeting was very informative with lots of new material. For the true “junkies” wanting new information, you can see all the abstracts here. I would be happy to try and expand or explain any of the abstracts you might find interesting to the best of my ability. It was fun meeting with all of the “old guard” prostate cancer researchers this year and it is an exciting time with the many new drugs, new approaches and young investigators entering the field.