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Widely used anti-nausea drug may interfere with cancer chemotherapy

A drug widely used to prevent nausea and other side effects in patients receiving chemotherapy for breast cancer may also, unfortunately, prevent the therapy from working efficiently on tumor cells, researchers from the University of Chicago report in the March 1 issue of the Journal, Cancer Research.

Dexamethasone, a synthetic steroid, is routinely given to women just before they receive chemotherapy with either paclitaxel or doxorubicin, two drugs commonly used to treat breast cancer. In this laboratory study, the researchers show that pretreatment with dexamethasone reduces the ability of paclitaxel and doxorubicin to kill cancer cells.

"Nearly every patient receiving chemotherapy for breast cancer also receives dexamethasone pre-treatments that may make therapy less effective," said Suzanne Conzen, M.D, assistant professor of medicine at the University of Chicago and director of the study. "With breast cancer one wants the best tumor reduction possible, but we have evidence that the benefits provided by routine treatment with dexamethasone may cause decreased chemotherapy-induced tumor cell death."

Conzen's team became suspicious nearly four years ago when they discovered that a group of steroid hormones know as glucocorticoids could inhibit death in certain cell types, including breast epithelial cells. This made them begin to question the wisdom of treating breast cancer patients with dexamethasone (known as Dex), an artificial glucocorticoid.

A careful search of the literature on dexamethasone uncovered another surprise. "Remarkably," the authors note, no clinical studies had ever addressed the potential effects on tumor response of administering Dex before routine chemotherapy for breast cancer.

To study these effects at the molecular level, Conzen's team devised a laboratory system that mimicked the usual clinical administration of dexamethasone in this setting. They found that pretreatment of breast cancer ce
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Contact: John Easton
jeaston@uchospitals.edu
773-702-6241
University of Chicago Medical Center
2-Mar-2004


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