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Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies

Steroid use is a widely accepted practice for both the treatment and prevention of tumor-induced edema, but there are many unknowns regarding their current clinical utility with modern anti-tumor therapies. This decreases edema and relieves the symptomatic mass effect. There are clearly understood b...

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Autores principales: Goldman, Matthew, Lucke-Wold, Brandon, Martinez-Sosa, Meleine, Katz, Jason, Mehkri, Yusuf, Valisno, Jeff, Quintin, Stephan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Open Exploration 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9630032/
https://www.ncbi.nlm.nih.gov/pubmed/36338521
http://dx.doi.org/10.37349/etat.2022.00106
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author Goldman, Matthew
Lucke-Wold, Brandon
Martinez-Sosa, Meleine
Katz, Jason
Mehkri, Yusuf
Valisno, Jeff
Quintin, Stephan
author_facet Goldman, Matthew
Lucke-Wold, Brandon
Martinez-Sosa, Meleine
Katz, Jason
Mehkri, Yusuf
Valisno, Jeff
Quintin, Stephan
author_sort Goldman, Matthew
collection PubMed
description Steroid use is a widely accepted practice for both the treatment and prevention of tumor-induced edema, but there are many unknowns regarding their current clinical utility with modern anti-tumor therapies. This decreases edema and relieves the symptomatic mass effect. There are clearly understood benefits and commonly accepted complications of methylprednisolone (MP) use, but the topic is recently controversial. With immunotherapy advancing, a robust immune response is crucial for full therapeutic efficacy. The immunosuppression of MP may interfere with future and current therapeutics relying on the integrity of the patient’s immune system. This further emphasizes the need for alternative agents to effectively treat tumor-induced cerebral edema. This review highlights the current clinical utility of steroids to treat brain tumor-related edema and the underlying pathophysiology. It also reviews details regarding different steroid formulations and dosing. Research available regarding concurrent steroid use with immunotherapy is detailed next, followed by alternatives to steroids and barriers to their adoption. Finally, this paper discusses pre-clinical findings and emerging treatments aimed to augment or replace steroid use.
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spelling pubmed-96300322022-11-04 Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies Goldman, Matthew Lucke-Wold, Brandon Martinez-Sosa, Meleine Katz, Jason Mehkri, Yusuf Valisno, Jeff Quintin, Stephan Explor Target Antitumor Ther Review Steroid use is a widely accepted practice for both the treatment and prevention of tumor-induced edema, but there are many unknowns regarding their current clinical utility with modern anti-tumor therapies. This decreases edema and relieves the symptomatic mass effect. There are clearly understood benefits and commonly accepted complications of methylprednisolone (MP) use, but the topic is recently controversial. With immunotherapy advancing, a robust immune response is crucial for full therapeutic efficacy. The immunosuppression of MP may interfere with future and current therapeutics relying on the integrity of the patient’s immune system. This further emphasizes the need for alternative agents to effectively treat tumor-induced cerebral edema. This review highlights the current clinical utility of steroids to treat brain tumor-related edema and the underlying pathophysiology. It also reviews details regarding different steroid formulations and dosing. Research available regarding concurrent steroid use with immunotherapy is detailed next, followed by alternatives to steroids and barriers to their adoption. Finally, this paper discusses pre-clinical findings and emerging treatments aimed to augment or replace steroid use. Open Exploration 2022 2022-10-31 /pmc/articles/PMC9630032/ /pubmed/36338521 http://dx.doi.org/10.37349/etat.2022.00106 Text en © The Author(s) 2022. https://creativecommons.org/licenses/by/4.0/This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Goldman, Matthew
Lucke-Wold, Brandon
Martinez-Sosa, Meleine
Katz, Jason
Mehkri, Yusuf
Valisno, Jeff
Quintin, Stephan
Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
title Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
title_full Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
title_fullStr Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
title_full_unstemmed Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
title_short Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
title_sort steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9630032/
https://www.ncbi.nlm.nih.gov/pubmed/36338521
http://dx.doi.org/10.37349/etat.2022.00106
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