Dexamethasone decreases the incidence of docetaxel-induced oral mucositis in patients suffering from breast cancer in a dose-dependent manner.
Pharmaceutical formulations containing docetaxel, an effective chemotherapeutic agent for the treatment of breast cancer, commonly lead to the development of oral mucositis (OM). To prevent the fluid retention that is associated with docataxel use in breast cancer patients, dexamethasone (DEX) is administered; however, dose-dependent effects of this drug have not been established.
This retrospective observational study demonstrated that an increase in DEX significantly decreased OM incidence; however, dysgeusia incidence was not significantly different across high- and low-dose groups. The findings are published in Scientific Reports.
Of 92 eligible patients, 45 were placed in the low-dose group and 47 were placed in the high-dose group. Compared to the low-dose group patients, high-dose group patients were older, had a greater body mass index (BMI), and had significantly lower levels of creatinine clearance and expression of human epidermal growth factor receptor 2 (HER2).
Incidence of Dysgeusia and Oral Mucositis
There was a significantly low rate of all-grade OM incidence in the high-dose group across all treatment cycles. OM incidence significantly decreased with the increase in the DEX dose. Conversely, the two groups did not differ significantly in the incidence of grade 2 OM. Similarly, the incidence of dysgeusia was not different in the high-dose and low-dose groups in the first and all treatment cycles.
Risk Factors for Oral Mucositis
A low DEX dose was found to be a singular independent risk factor in the development of OM in breast cancer patients.
Adverse Effects of Dexamethasone
No breast cancer patient included in this study developed grade 3/4 severe symptoms or pneumocystis pneumonia. Adverse effects related to the dosage of DEX included nausea, febrile neutropenia, insomnia, anorexia, and fatigue; however, the incidence of these adverse events was not different across the high-dose and low-dose groups.
DEX decreases the incidence of docetaxel-induced OM in patients suffering from breast cancer in a dose-dependent manner; however, the dose-dependent effect is not evident for the incidence of dysgeusia.
Saito, Y., Takekuma, Y., Takeshita, T., Oshino, T., & Sugawara, M. (2023). Impact of systemic dexamethasone dosage on docetaxel-induced oral mucositis in patients with breast cancer. Scientific Reports, 13(1). https://doi.org/10.1038/s41598-023-37285-9