Published September 30, 2022
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Corticosteroids in oncology: Use, overuse, indications, contraindications. An Italian Association of Medical Oncology (AIOM)/ Italian Association of Medical Diabetologists (AMD)/ Italian Society of Endocrinology (SIE)/ Italian Society of Pharmacology (SIF) multidisciplinary consensus position paper.

Creators

  • 1. Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University of Rome, Rome, Italy. Electronic address: antongiulio.faggiano@uniroma1.it.
  • 2. Sapienza University of Rome
  • 3. Endocrinology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, ENETS Center of Excellence, Sapienza University of Rome, Rome, Italy.
  • 4. Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
  • 5. University of Bari
  • 6. Endocrinology and Diabetology Unit, ASL Verbano Cusio Ossola, Domodossola, Italy.
  • 7. Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.
  • 8. Scientific Institute for Research, Hospitalization and Healthcare
  • 9. Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • 10. University of Pisa
  • 11. Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy.
  • 12. Endocrinology and Metabolic Diseases Unit, AO SS Antonio e Biagio e Cesare Arrigo of Alessandria, Alessandria, Italy.
  • 13. Department of Oncology, Istituto Oncologico del Mediterraneo, Viagrande, Catania, Italy.
  • 14. Oncologia Medica, IRCCS Ospedale Don Calabria-Sacro Cuore di Negrar, Verona, Italy.
  • 15. Department of Biomedical Sciences and Human Oncology - Section of Pharmacology, Medical School - University of Bari Aldo Moro, Bari, Italy.
  • 16. Diabetologist and Endocrinologist, Italian Association of Clinical Diabetologists, Italy.
  • 17. Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy.
  • 18. Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
  • 19. Diabetology, Endocrinology and Metabolic Diseases Service, ASL-Sulcis, Italy.
  • 20. Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy.
  • 21. Endocrinology, Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy; UNESCO Chair, Education for Health and Sustainable Development, Federico II University, Naples, Italy.
  • 22. Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Italy.

Description

Corticosteroids (CSs) are widely used in oncology, presenting several different indications. They are useful for induction of apoptosis in hematological neoplasms, for management of anaphylaxis and cytokine release/hypersensitivity reaction and for the symptomatic treatment of many tumour- and treatment-related complications. If the employment of CSs in the oncological setting results in several benefits for patients and satisfaction for clinicians, on the other hand, many potential adverse events (AEs), both during treatment and after withdrawal of CSs, as well as the duality of the effects of these compounds in oncology, recommend being cautious in clinical practice. To date, several gray zones remain about indications, contraindications, dose, and duration of treatment. In this article, a panel of experts provides a critical review on CSs therapy in oncology, focusing on mechanisms of action and pharmacological characteristics, current and emerging therapeutic indications/contraindications, AEs related to CSs treatment, and the impact on patient outcome.
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