Corticosteroid — Anti-inflammatory oncology medication

Corticosteroids—such as dexamethasone, prednisolone, and methylprednisolone—are synthetic steroid hormones possessing potent anti-inflammatory and immunosuppressive properties. They function by binding to glucocorticoid receptors in the cytoplasm, translocating into the cell nucleus, and modulating the transcription of specific genes. This action impedes the synthesis of pro-inflammatory cytokines, chemokines, and inflammatory enzymes, mitigating tissue oedema and immune-mediated cell damage.

Beyond symptom relief, corticosteroids exert direct pro-apoptotic effects on malignant lymphoid cells. By arresting the cell cycle and activating programmed cell death cascades, these agents demonstrate direct anti-neoplastic efficacy in lymphoid tumours. Their clinical use spans multiple indications, from decreasing peri-tumoural brain oedema in patients with central nervous system metastases to alleviating hypersensitivity reactions associated with infusion drugs.

Corticosteroids are among the most frequently prescribed drugs in oncology, making it vital for patients to understand their benefits and side effects. While they bring rapid relief from pain, nausea, and swelling, short-term use can alter sleep, mood, appetite, and blood sugar levels. Prolonged use requires careful tapering to prevent adrenal insufficiency. Being aware of these aspects allows patients to monitor changes, protect bone and metabolic health, and avoid stopping the drug abruptly.

Corticosteroid use does not depend on a specific biomarker, but it requires careful patient monitoring. Clinicians monitor blood glucose levels, blood pressure, electrolyte balances, and bone mineral density (via DEXA scans). When managing immune-related toxicities from checkpoint inhibitors, stool or endoscopy tests help evaluate corticosteroid response.

Corticosteroids are therapeutic cornerstones in multiple myeloma, acute lymphoblastic leukaemia, chronic lymphocytic leukaemia, and non-Hodgkin lymphomas. They are also widely used across solid tumours, such as breast, lung, colorectal, and prostate cancers, primarily for supportive symptom management and combating brain metastases.

These medications are integrated into standard antiemetic regimens alongside 5-HT3 and NK1 antagonists. They serve as primary interventions for immune-related adverse events triggered by immunotherapy, although careful timing is needed to avoid dampening the immunotherapy's anti-tumour efficacy. Doses are tapered gradually under clinical oversight.