Phase III placebo-controlled, double-blind, randomized trial of pegfilgrastim to reduce the risk of febrile neutropenia in breast cancer patients receiving docetaxel/cyclophosphamide chemotherapy

Support Care Cancer. 2015 Apr;23(4):1137-43. doi: 10.1007/s00520-014-2597-1. Epub 2015 Jan 10.

Abstract

Purpose: Pegfilgrastim is a pegylated form of filgrastim, a recombinant protein of granulocyte colony-stimulating factor, that is used to reduce the risk of febrile neutropenia (FN). Here, we report the results of a phase III trial of pegfilgrastim in breast cancer patients receiving docetaxel and cyclophosphamide (TC) chemotherapy.

Methods: We conducted a double-blind, placebo-controlled, randomized trial to determine the efficacy of pegfilgrastim in reducing the risk of FN in early-stage breast cancer patients. A total of 351 women (177 in the pegfilgrastim group and 174 in the placebo group) between 20 and 69 years of age with stage I-III invasive breast carcinoma who were to receive TC chemotherapy (docetaxel 75 mg/m(2) and cyclophosphamide 600 mg/m(2) every 3 weeks) as either neoadjuvant or adjuvant therapy were enrolled; 346 of these patients were treated with either pegfilgrastim (n = 173) or placebo (n = 173).

Results: The incidence of FN was significantly lower in the pegfilgrastim group than in the placebo group (1.2 vs. 68.8 %, respectively; P < 0.001). In addition, patients in the pegfilgrastim group required less hospitalization and antibiotics for FN. Most adverse events were consistent with those expected for breast cancer subjects receiving TC chemotherapy.

Conclusions: Pegfilgrastim is safe and significantly reduces the incidence of FN in breast cancer patients.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Chemotherapy, Adjuvant
  • Chemotherapy-Induced Febrile Neutropenia / drug therapy*
  • Chemotherapy-Induced Febrile Neutropenia / prevention & control
  • Cyclophosphamide / adverse effects
  • Double-Blind Method
  • Doxorubicin / adverse effects
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Humans
  • Middle Aged
  • Polyethylene Glycols
  • Prognosis
  • Recombinant Proteins / administration & dosage
  • Risk
  • Survival Rate
  • Taxoids / adverse effects
  • Treatment Outcome

Substances

  • Recombinant Proteins
  • Taxoids
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Doxorubicin
  • Cyclophosphamide
  • Filgrastim

Supplementary concepts

  • TAC protocol