Janowitz, Tobias, Kleeman, Sam, Vonderheide, Robert H (April 2021) Reconsidering Dexamethasone for Antiemesis when Combining Chemotherapy and Immunotherapy. The Oncologist, 26 (4). pp. 269-273. ISSN 1083-7159
Abstract
Whether the immune suppressive action of glucocorticoid steroids, such as dexamethasone, might reduce the benefits of cancer immunotherapy has long been a concern. Observations that established tumor regressions in response to immune checkpoint inhibitors (ICIs) often persist, despite the use of steroids to mitigate ICI-related autoimmune breakthrough, are not sufficiently reassuring, because these observations do not address the potential blunting of immune priming at the initiation of ICI therapy. With increasing indications for ICI in combination with chemotherapy, this issue merits reconsideration. Professional society guidance advises that dexamethasone should be used as first-line prophylaxis for nausea and vomiting in patients receiving ICI and highly emetogenic chemotherapy combination regimens. Here, we review the availability of data on this subject and propose an alternative approach focused on the adoption of steroid minimization or sparing for prophylaxis of nausea until the underlying immune biology is better understood.
| Item Type: | Paper |
|---|---|
| Subjects: | diseases & disorders > cancer diseases & disorders diseases & disorders > neoplasms diseases & disorders > cancer > drugs and therapies > chemotherapy diseases & disorders > cancer > drugs and therapies diseases & disorders > cancer > drugs and therapies > Immunotherapy diseases & disorders > nausea |
| CSHL Authors: | |
| Communities: | CSHL Cancer Center Program CSHL Cancer Center Program > Cancer Genetics and Genomics Program CSHL labs > Janowitz lab School of Biological Sciences > Publications |
| SWORD Depositor: | CSHL Elements |
| Depositing User: | CSHL Elements |
| Date: | April 2021 |
| Date Deposited: | 28 Apr 2021 19:35 |
| Last Modified: | 29 Feb 2024 17:11 |
| PMCID: | PMC8018330 |
| URI: | https://repository.cshl.edu/id/eprint/39947 |
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