Low Doses of Dexamethasone as monothe... - Advanced Prostate...

Got it, thank you. We have appointment with onco on Monday. My dad has mCRPC, Xtandi is not working anymore. As for scans, his cancer is spread to lymph nodes, but it was only CT scan and bone scan, no PET CT. So based on scan Xofigo is not indicated and Pluvicto is not available in our country. Seems chemo is the only option? He is 81 and I’m not sure he will be willing to travel abroad for Pluvicto or try chemo. He has no comorbidities, but is increasingly more tired and sleeps a lot even during the day (not sure if it is from Xtandi or disease itself).

GP242 years ago

Dexamethasone reduces the testosterone produced by the adrenal cortex and limits the inflammation caused by the tumor. I would add 1.0 mg Dexa to the current treatment and monitor if and how long it works using the PSA value. It cannot be used as a monotherapy but you can combine it with Eligard.

MyDad76• in reply toGP242 years ago

Thank you, will def. bring it to the table on Monday, when we have appointment with onco. It seems we have nothing / very little to lose at this stage.

FCoffey2 years ago

Take a look at

Assessment of the Safety of Glucocorticoid Regimens in Combination With Abiraterone Acetate A Randomized, Open-Label Phase 2 Study

ncbi.nlm.nih.gov/pmc/articl...

Median radiographic progression-free survival was

18.5 months with prednisone, 5 mg, twice daily,

15.3 months with prednisone, 5 mg, once daily,

12.8 months with prednisone, 2.5mg, twice daily,

26.6months with dexamethasone 0.5 mg daily.

I discussed this article with my oncologist 4 years ago (almost to the day) and we agreed to substitute dexamethasone for prednisone while taking abiraterone. So far so good. Last MRI reported no progression.