Background: Chemotherapy is associated with many adverse side effects including nausea, myalgia, and emotional stress. Some providers recommend three days of dexamethasone (supplemental dexamethasone) following chemotherapy in an effort to mitigate these toxicities. This study seeks to determine if supplemental dexamethasone affects patient-reported outcomes in patients receiving carboplatin and paclitaxel. Methods: Patients with gynecologic malignancies receiving carboplatin and paclitaxel every 3 weeks were eligible. In this prospective case-control study, patients receiving (cases) supplemental dexamethasone (8mg once daily x 3 days starting on post-chemotherapy day 1) were compared with those patients that did not receive delayed dexamethasone (controls). Decision for supplemental dexamethasone was based on provider’s discretion. The FACT-G7, a validated survey assessing the impact of chemotherapy on patients’ quality of life, was administered by telephone one week after each chemotherapy cycle for up to 6 cycles. Pain during post-chemotherapy days 1-3 was also assessed with an additional survey question. FACT-G7 composite score was our primary outcome of interest. The student’s t-test was used to compare the FACT-G7 and average pain scores between cases and controls at each survey point. Results: Fifty-two patients were enrolled, 26 received supplemental dexamethasone and 26 did not. At interim analysis, 94% of subjects have completed all 6 survey time points. The initial response rate was 98.0%. FACT-G7 scores (Table) were significantly higher, corresponding to less symptoms, in patients treated with supplemental dexamethasone after cycles 4-6. Pain scores in post-chemotherapy days 1-3 were lower following cycle 3 for the supplemental dexamethasone group (p=.0083). Conclusions: Supplemental dexamethasone after carboplatin and paclitaxel for patients with gynecologic malignancies improves patient-reported outcomes. This improvement was limited to cycles 4-6, suggesting possible mitigation of cumulative chemotherapy toxicities.