Risks in Antiemesis Using Dexamethasone

Excerpt

To the editor: Cassileth and colleagues (1) have shown that high-dose dexamethasone therapy alleviates cancer therapy-induced emesis while producing less toxicity than other commonly used antiemetics. Before dexamethasone becomes the antiemetic of choice for cancer therapy, however, its effect on chemotherapy response rates, response durations, and survival must be determined.

Several clinical and experimental studies have indicated that high-dose or prolonged corticosteroid treatment adversely affects chemotherapy efficacy. In one study, patients with metastatic lung cancer were randomly assigned to receive intermittent high-dose cyclophosphamide with or without prednisolone, 100 mg/m² orally for 2 days. The response rate was 57% for cyclophosphamide