Investigating HPA Axis Function in Women Undergoing Chemotherapy with Adjunctive High-Dose Dexamethasone: A Prospective Pilot Study - Scorecard - MDSpire

Investigating HPA Axis Function in Women Undergoing Chemotherapy with Adjunctive High-Dose Dexamethasone: A Prospective Pilot Study

  • By

  • Elżbieta Turska

  • Krzysztof Lewandowski

  • Igor Symonowicz

  • Magdalena Kobus

  • Wojciech Horzelski

  • Tomasz Kubiatowski

  • Justyna Marchewka-Długońska

  • Ewa Kalinka

  • April 23, 2026

  • 0 min

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Clinical Scorecard: Investigating HPA Axis Function in Women Undergoing Chemotherapy with Adjunctive High-Dose Dexamethasone: A Prospective Pilot Study

At a Glance

CategoryDetail
ConditionGlucocorticoid-induced adrenal insufficiency (GIAI)
Key MechanismsIntermittent high-dose dexamethasone potentially suppresses HPA axis function.
Target PopulationWomen with breast cancer undergoing paclitaxel-based chemotherapy.
Care SettingOncology clinic

Key Highlights

  • Study involved 47 women with breast cancer receiving dexamethasone.
  • No significant changes in morning cortisol or ACTH concentrations were observed.
  • Findings suggest limitations of single cortisol measurements.
  • Need for longitudinal assessment of adrenal function in oncology patients.
  • Dynamic testing is recommended for evaluating HPA axis function.

Guideline-Based Recommendations

Diagnosis

  • Assess adrenal function biochemically with morning serum cortisol levels.
  • Consider dynamic testing with synthetic ACTH for accurate evaluation.

Management

  • Monitor for symptoms of adrenal insufficiency in patients receiving dexamethasone.

Monitoring & Follow-up

  • Longitudinal monitoring of cortisol and ACTH concentrations is advised.

Risks

  • Iatrogenic adrenal insufficiency may occur due to glucocorticoid therapy.

Patient & Prescribing Data

Women aged 33-81 with breast cancer.

Dexamethasone is commonly used as premedication in chemotherapy.

Clinical Best Practices

  • Use caution when interpreting morning cortisol levels due to circadian influences.
  • Recognize overlapping symptoms of adrenal insufficiency and chemotherapy side effects.

References

Original Source(s)

Investigating HPA Axis Function in Women Undergoing Chemotherapy with Adjunctive High-Dose Dexamethasone: A Prospective Pilot Study

  • by Elżbieta Turska, Krzysztof Lewandowski, Igor Symonowicz, Magdalena Kobus, Wojciech Horzelski, Tomasz Kubiatowski, Justyna Marchewka-Długońska, Ewa Kalinka

  • April 23, 2026

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