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Dexamethasone is a long-acting glucocorticoid steroid that kills lymphoid cancer cells directly, which is why it sits in nearly every myeloma regimen and in childhood leukaemia and lymphoma protocols. It is also the standard drug for preventing chemotherapy sickness and for brain swelling and spinal cord compression; high blood sugar, insomnia, muscle wasting and infection follow prolonged use.
Dexamethasone was approved in 1958 and is labelled for palliative management of leukaemias and lymphomas among dozens of inflammatory indications; in oncology it is the steroid of virtually every multiple myeloma regimen (with bortezomib, lenalidomide, daratumumab and the newer antibodies), of paediatric ALL induction where it replaced prednisone in several protocols, and of the R-CHOP-like and hyper-CVAD regimens. Hemady (20 mg tablets, 2019) is a US product labelled specifically for multiple myeloma, and Neofordex (40 mg tablets) was authorised in the EU in 2016 for the same disease. It is also first-line antiemetic prophylaxis, the standard for tumour-associated brain oedema and spinal cord compression, and a premedication for taxanes and pemetrexed. Hyperglycaemia, insomnia, myopathy, infection and adrenal suppression follow prolonged use.
Synthetic glucocorticoid receptor agonist; lympholytic in leukaemia, lymphoma and myeloma, anti-inflammatory and antiemetic through genomic and non-genomic actions.
1.Dexamethasone acts on its target, the hormone receptor or the enzyme that makes the hormone.
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FDA grants accelerated approval to iberdomide with daratumumab and hyaluronidase-fihj and dexamethasone for multiple myeloma source
| Region | Year | Indication |
|---|---|---|
| US | 1958 | Palliative management of leukaemias and lymphomas; inflammatory and allergic conditions |
| US | 2019 | Multiple myeloma in combination with other antimyeloma products (Hemady) |
| EU | 2016 | Multiple myeloma in combination (Neofordex) |
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Quadruplet induction with a CD38 antibody became the standard for transplant-eligible patients in Europe. PERSEUS later did the same with the lenalidomide-based backbone used elsewhere.
Upfront transplant remains standard for fit patients because it lengthens the first remission, but deferring it to first relapse is a reasonable choice for some, particularly with deeper modern induction.
One of the few maintenance strategies in lymphoma that improved overall survival rather than only progression-free survival, and the reason three years of rituximab became standard after autologous transplantation in mantle cell lymphoma.
High-dose methotrexate interim maintenance and age-adapted steroid choice are standard in high-risk paediatric B-ALL protocols.
Bortezomib-based induction with early transplant consolidation became the accepted approach for fit patients with this rare aggressive disease; daratumumab-containing quadruplets are now added by extrapolation.
Whole-brain radiotherapy is not a default for poor-prognosis brain metastases; supportive care alone is an acceptable choice, with radiotherapy reserved for selected younger, fitter patients.
The regimen that made extranodal NK/T-cell lymphoma treatable. The usual explanation is that asparaginase is not a substrate of the P-glycoprotein pump this tumour expresses, which would explain why it works where anthracycline-based regimens do not; that mechanism is widely repeated but has been contradicted by at least one series.
Query for this drug: (TITLE:"Dexamethasone" OR ABSTRACT:"Dexamethasone" OR TITLE:"Decadron" OR ABSTRACT:"Decadron" OR TITLE:"historic" OR ABSTRACT:"historic" OR TITLE:"Hemady" OR ABSTRACT:"Hemady" OR TITLE:"Neofordex" OR ABSTRACT:"Neofordex") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Dexamethasone, not a curated reading list.
Shares A Study to Evaluate the Safety, Tolerability, and Efficacy of MORAb-202 (Herein Referred to as Farletuzumab Ecteribulin), a Folate Receptor Alpha (FRα)-Targeting Antibody-drug Conjugate (ADC) in Participants With Selected Tumor Types, Glucocorticoid receptor (NR3C1), Chemotherapy With or Without Strontium-89 in Treating Patients With Prostate Cancer, Substudy 01A: Safety and Efficacy of Opevesostat (MK-5684)-Based Treatment Combinations or Opevesostat Alone in Participants With Metastatic Castration-resistant Prostate Cancer (mCRPC) (MK-5684-01A) and the tags generic, supportive.
Shares Hikma Pharmaceuticals, Aprepitant (and fosaprepitant), Oral solid dose manufacturing (tablets and capsules), Antiemetics for chemotherapy-induced nausea and vomiting and the tags generic, supportive.
Shares Dexamethasone With or Without Thalidomide in Treating Patients With Newly Diagnosed Multiple Myeloma, Palliation in advanced triple-negative breast cancer: brain, bone, pleura, skin and end of life, Bone metastases and skeletal-related events, Multiple myeloma and the tags generic, supportive.
Shares Study 3 (rolapitant, moderately emetogenic chemotherapy), Antiemetics for chemotherapy-induced nausea and vomiting and the tags generic, supportive.
Shares Dexamethasone With or Without Thalidomide in Treating Patients With Newly Diagnosed Multiple Myeloma, Multiple myeloma and the tags generic, supportive.
Shares A Study of MK-5684 in People With Certain Solid Tumors (MK-5684-015/OMAHA-015) and the tags generic, supportive.
Shares the tags generic, supportive.
Shares Treatment of Patients With Newly Diagnosed Acute Myeloid Leukemia or Myelodysplasia, Treatment Protocol of the NHL-BFM and the NOPHO Study Groups for Mature Aggressive B-cell Lymphoma and Leukemia in Children and Adolescents, Inotuzumab Ozogamicin and Frontline Chemotherapy in Treating Young Adults With Newly Diagnosed B Acute Lymphoblastic Leukemia, Safety and Efficacy of Asciminib in Pediatrics and Young Adults With Relapse/Refractory (r/r) Philadelphia Positive (Ph+) or ABL-class Ph-like Acute Lymphoblastic Leukemia (ALL) and the tag generic.