It's not that dexamethasone is stronger, it's that it is different from prednisone and the cancer can start feeding on prednisone. Just search for abiraterone and dexamethasone in the posts and you'll see many discussions on the topic.
Keep in mind that long term (years) steroid use can lead to the development of cataracts. which I have. As always, there are positives and negatives for every treatment.
I have not been able to find any studies showing that switching from prednisone to dexamethasone might make the abiraterone start working again. Does anyone have any studies I can use to show my MO IF the current abi + prednisone stops working?
Here's an excerpt from "Lessons from the SWITCH trial" which is one of several papers on the topic:Several hypotheses have been proposed to explain the responses observed in the earlier SWITCH study2 including, but not limited to: [I] the emergence or selection of cells with secondary AR mutations that are activated by prednisone but not dexamethasone;8 [II] a differential downstream transcriptional effect of 0.5 mg of dexamethasone versus 10 mg of prednisone in cells overexpressing the GR as a bypass mechanism to AR inhibition and [III] secondary activation of the mineralocorticoid receptor, which has higher affinity for prednisone.
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