Low-dose dexamethasone may be preferred as a premedication protocol for patients receiving weekly docetaxel regimens due a significantly lower risk of infection compared with a higher dose regimen, a study published in the journal Supportive Care in Cancer has shown.1
Because docetaxel administered weekly has demonstrated comparable efficacy with a tri-weekly schedule and is associated with significantly less severe neutropenia and febrile neutropenia, the use of weekly docetaxel has become increasingly more common for the treatment of cancer.
However, docetaxel treatment is still associated with hypersensitivity reactions and fluid retention. Therefore, premedication with corticosteroids are used to minimize these risks, but the optimal steroid dosage for a weekly docetaxel regimen remains unclear.
For the study, investigators analyzed data from 206 patients undergoing weekly docetaxel. Of those, 109 received dexamethasone 10 mg intravenously and 4 mg orally every 12 hours for 4 doses, beginning 1 hour before docetaxel administration, and 97 received dexamethasone 10 mg intravenously 1 hour prior to chemotherapy administration.
Results showed no significant differences in the incidence of hypersensitivity or hyperglycemia between the arms; however, researchers found that patients who received low-dose dexamethasone experienced significantly fewer infections (odds ratio, 0.408; 95% CI, 0.0190-0.0879; P =.020).
The findings suggest that a low-dose dexamethasone premedication may be as effective at preventing docetaxel hypersensitivity while reducing infection complications.
1. Kang RY, Yoo KS, Han HJ, et al. Evaluation of the effects and adverse drug reactions of low-dose dexamethasone premedication with weekly docetaxel. Supp Care Cancer. 2016 Sep 30. doi: 10.1007/s00520-016-3420-y.