Investigator Perspectives on Emerging Concepts in the Management of Genitourinary CancersUse of corticosteroids with abiraterone; fatigue with enzalutamide
2:09 minutes.
TRANSCRIPTION:
DR GOMELLA: I was able to participate in a large, multi-institutional study looking at over 2,000 patient years, basically, of abiraterone, with and without steroids, and placebo arms. And essentially, there was really not a significant increase in toxicity that you could ascribe to specifically the addition of the prednisone with the abiraterone. That paper’s been presented at multiple venues. It’s currently in circulation, at a journal for publication. But from a toxicity standpoint of adding the steroid in, more for the urologists that are prescribing abiraterone as opposed to the medical oncologists, I think you could safely say that that low dose of prednisone does not cause any specific corticosteroid-related toxicity. DR LOVE: And that’s what I’ve been hearing when I’ve asked people about their own clinical experiences, that they rarely do see a problem. Is that the case with you? DR GOMELLA: Yes. I think, again — we have a multidisciplinary center, and we’re arm in arm with our medical oncologists and we jointly manage these patients together. But I rarely see someone having abiraterone stopped for problems with blood sugar control or severe hypertension or anything else in that line. The issue that’s coming up with enzalutamide is, it’s very easy to administer compared to the abiraterone that requires the steroid. But one of the things that is coming up lately is the concern about fatigue and falls. And this is something that may not have been well documented in the early trials, but there are concerns about some weakness. And no one’s sure if it’s actually weakness causing the falls, fatigue causing the falls or some other central nervous system-related event. So we do warn people who are on the enzalutamide to just be a little bit more mindful. They might be a little bit more unstable on their feet. But again, that is getting some concern. |