Perioperative dexamethasone in high-grade gliomas: the short-term benefits and long-term harms

Abstract

Dexamethasone has been commonly given to patients with a presumed new GBM in relatively large doses (6-16 mg daily for 1-2 weeks) since the 1960s without any rigorous evidence. This treatment with dexamethasone before the diagnosis and adjuvant therapy makes GBM patients unique compared to other newly diagnosed cancer patients. While dexamethasone may be beneficial, recent studies suggest that this potent immunosuppressant with pleiotropic effects is harmful in the long term. This perspective article summarizes the disadvantages of perioperative dexamethasone from multiple facets. It concludes that these growing data mandate rigorously testing the benefits of using perioperative dexamethasone.

Exploring Gut Microbiota Alterations with Trimethoprim-Sulfamethoxazole and Dexamethasone in a Humanized Microbiome Mouse Model

“…Additionally, 3 wk post txt tryptophan metabolism, xenobiotics degradation metabolism did not recover. This could potentially indicate that there may be potential long-term effects of dexamethasone [13,47].…”

“…Dexamethasone is a potent glucocorticoid steroid drug that acts as an anti-inflammatory agent or immunosuppressant by increasing glucogenesis and blocking inflammatory mediators [11,12]. Dexamethasone is commonly used to reduce cerebral edema, a side effect of standard care treatment for patients with GBM [12,13]. In recent studies, dexamethasone has been linked to shortened survival and decreased immunotherapy efficacy in GBM models [12][13][14].…”

“…Dexamethasone is commonly used to reduce cerebral edema, a side effect of standard care treatment for patients with GBM [12,13]. In recent studies, dexamethasone has been linked to shortened survival and decreased immunotherapy efficacy in GBM models [12][13][14]. TMP-SMX is a broad-spectrum combination antibiotic [15].…”