Febrile neutropenia and related complications in breast cancer patients receiving pegfilgrastim primary prophylaxis versus current practice neutropaenia management: Results from an integrated analysis

• Published in: European journal of cancer (1990) Vol. 45; no. 4; pp. 608 - 617
• Main Authors: von Minckwitz, G, Schwenkglenks, M, Skacel, T, Lyman, G.H, Pousa, A. Lopez, Bacon, P, Easton, V, Aapro, M.S
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-03-2009; Elsevier
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Biological and medical sciences; Breast neoplasms; Breast Neoplasms - drug therapy; Drug Administration Schedule; Drug therapy; Female; Fever - prevention & control; Filgrastim; Granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - therapeutic use; Hematology, Oncology and Palliative Medicine; Human; Humans; Leukopenia - chemically induced; Leukopenia - prevention & control; Male; Medical sciences; Middle Aged; Neutropaenia/chemically induced; Neutropenia - chemically induced; Neutropenia - prevention & control; Opportunistic Infections - prevention & control; Pegfilgrastim; Pharmacology. Drug treatments; Polyethylene Glycols; Primary prevention; Recombinant Proteins; Taxane; Treatment Outcome; Tumors; Human; Pegfilgrastim; Granulocyte colony-stimulating factor; Primary prevention; Neutropaenia/chemically induced; Breast neoplasms; Taxane; Drug therapy; Breast disease; Breast tumor; Pharmacotherapy; Hemopathy; Prevention; Granulocyte colony stimulating factor; Cancerology; Taxane derivatives; Primary; Complication; Pegylated form; Neutropenia; Primary cancer; Leukopenia; Cytokine; Breast cancer; Malignant tumor; Fever; Mammary gland diseases; Treatment; Clinical management; Comparative study; Cancer
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2008.11.021

Abstract Granulocyte colony-stimulating factors (G-CSFs) reduce febrile neutropaenia (FN) incidence but may be used inconsistently in current practice (CP). This study compared the efficacy of pegfilgrastim primary prophylaxis (PPP) with CP neutropaenia management in breast cancer. Individual patient data ( N = 2282) from 11 clinical trials and observational studies using chemotherapy regimens with ⩾15% FN risk and PPP (6 mg, all cycles) or CP (no G-CSF or any cycle G-CSF/pegfilgrastim) were included in an integrated analysis. Most patients received docetaxel-containing regimens. A generalised linear mixed model was fitted ( N = 2210). Neutropaenia prophylaxis (PPP versus CP), age and disease stage influenced the incidence of FN. Overall, FN was less frequent with PPP than with CP (odds ratio [OR]: 0.124; 95% confidence interval [CI]: 0.08, 0.194; P < 0.0001). Odds for cycle 1 FN, dose reductions ⩾ 15% and FN-related hospitalisation were also significantly lower with PPP. These data support PPP in breast cancer patients receiving chemotherapy with moderately high/high FN risk.