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.
prost8blog 
In view of the prednisone effect on my teeth and the news in this blog as well as my spinal stenosis problem might it be wise to not take prednisone when Ai restart Zytiga ??
Jim
Sent from my iPhone
Pred is required w Zytiga due to hypertension, hypokalemia, etc. caused by Zytiga
Sent from my iPhone, please excuse brevity Mike.Glode@ucdenver.edu
Dr Glode,
Thank you for posting these abstaracts.
I find your study with cytozan/cyclophosphamide / and LD Dex very interesting.Was it oral cytozan or IV? Was it Cytozan that was used along with 5FU during the Servadio Study in D2 Patients, and offered the best survival ever in those patients ?
Is Dexamethesone a corticosteroid?
My Dr has me on just 5mg Prednisone with my Zytiga.
Interesting to note study No. 68 gave 48 Month survival , I think that was twice what I had heard from the same institution in 06, So I call that progress. I am thankful for every Day and feel very lucky to be here in a time when so many breakthroughs have been made.
Thanks,
Dan
Okay, so would a person do better without the prednisone when taking Zytiga? Don
Perhaps for the unwashed public, all non-randomized, non-blinded, non-controlled trials should be labelled, CAUTION: evaluate study limitations.
Gzr
you have to take pred with zytiga
see above