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Progesterone is more effective than dexamethasone in prolonging overall survival and preserving neurologic functions in experimental animals with orthotopic glioblastoma allografts.

Al's Comment:

 An alternative to dexamethasone is badly needed, especially when using immunotherapies or Optune.  This may be one such alternative but the experiment was done in rats.  Need to wait until it is tested in people before using it.  


Posted on: 02/13/2019

World Neurosurg. 2019 Jan 30. pii: S1878-8750(19)30211-6. doi: 10.1016/j.wneu.2019.01.113. [Epub ahead of print]
Progesterone is more effective than dexamethasone in prolonging overall survival and preserving neurologic functions in experimental animals with orthotopic glioblastoma allografts.
Cheng Y1, Yeung WL2, De Zhang P3, Li N4, Kiang MY5, Leung KK6.
 
Author information:
1. Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, People's Republic of China. Electronic address: yincyns@hku.hk.
2. Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, People's Republic of China. Electronic address: ryo168jp@hku.hk.
3. Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, People's Republic of China. Electronic address: pingder@hku.hk.
4. Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, People's Republic of China. Electronic address: ningli.md@gmail.com.
5. Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, People's Republic of China. Electronic address: kkarrie@hku.hk.
6. Division of Neurosurgery, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, People's Republic of China; Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong SAR, People's Republic of China. Electronic address: gilberto@hku.hk.
Abstract
OBJECTIVE:
 
Dexamethasone (DEXA) is widely used in the management of peri-tumoral brain edema. DEXA, however, has many systemic side-effects, and may interact negatively with glioma therapy. Progesterone (PROG), on the other hand, is a well-tolerated and readily accessible anti-inflammatory and anti-edema agent with potent neuroprotective properties. We investigated if PROG can serve as a viable alternative to DEXA in the management of peri-tumoral brain edema.
METHODS:
 
We used an orthotopic C6 glioblastoma model with male Sprague-Dawley (SD) rats. Tumor grafts were allowed to grow for 14 days prior to drug treatment with (i) DEXA 1mg/kg, (ii) PROG 10mg/kg or (iii) PROG 20 mg/kg for five consecutive days. Overall animal survival and neurologic functions were evaluated. Mechanistic studies on blood brain barrier (BBB) permeability and angiogenic responses were performed on the ex vivo tumor grafts.
RESULTS:
 
We found that all drug treatments prolonged overall survival to different extents. PROG 10mg led to significantly longer survival, and better preservation of neurologic functions and body weight. BBB permeability was better preserved with PROG 10mg than DEXA possibly through the downregulation of MMP-9 and AQP-4 expressions; anti-angiogenic responses were also observed in the PROG group.
CONCLUSIONS:
 
This proof-of-concept pilot study provides novel information on the use of PROG as a corticosteroids-sparing agent in brain tumor management. Further translational and clinical studies are warranted.

 


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