Utilisation of primary and secondary G-CSF prophylaxis enables maintenance of optimal dose delivery of standard adjuvant chemotherapy for early breast cancer: an analysis of 1655 patients

Arlene Chan; Scott McGregor; Wenbin Liang

doi:10.1016/j.breast.2014.07.004

Utilisation of primary and secondary G-CSF prophylaxis enables maintenance of optimal dose delivery of standard adjuvant chemotherapy for early breast cancer: an analysis of 1655 patients

Breast. 2014 Oct;23(5):676-82. doi: 10.1016/j.breast.2014.07.004. Epub 2014 Aug 6.

Authors

Arlene Chan¹, Scott McGregor², Wenbin Liang³

Affiliations

¹ Curtin University, Western Australia 6000, Australia; Breast Cancer Research Centre-WA, Western Australia 6000, Australia. Electronic address: [email protected].
² Breast Cancer Research Centre-WA, Western Australia 6000, Australia.
³ National Drug Research Institute, Health Science, Curtin University, Western Australia 6000, Australia.

PMID: 25108452
DOI: 10.1016/j.breast.2014.07.004

Abstract

Optimal outcome for early breast cancer patients receiving adjuvant chemotherapy requires adequate dose delivery, commonly defined as >85% of planned dose of chemotherapy agents. Outside the clinical trial setting, reports from community oncology centres have demonstrated that a significant proportion of patients fail to receive this dose intensity, with neutropenia being the most commonly cited reason for sub-optimal treatment. Data collected prospectively on 1655 patient treated in a single breast cancer centre demonstrates that patients at risk of sub-optimal dose delivery can be identified by routine assessment of neutropenic events during the first cycle. The uniform administration of secondary G-CSF for all subsequent cycles enables dose delivery ≥85%, which was shown to lead to improved survival outcomes when compared with those patients who received <85%.

Keywords: Breast cancer; First cycle nadir; G-CSF use; Relative dose intensity.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Adenocarcinoma / drug therapy*
Adenocarcinoma / mortality
Adenocarcinoma / surgery
Adult
Aged
Aged, 80 and over
Antineoplastic Agents / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
Antineoplastic Combined Chemotherapy Protocols / adverse effects
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Breast Neoplasms / drug therapy*
Breast Neoplasms / mortality
Breast Neoplasms / surgery
Chemotherapy, Adjuvant
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Granulocyte Colony-Stimulating Factor / therapeutic use*
Hematologic Agents / therapeutic use*
Humans
Mastectomy*
Middle Aged
Neutropenia / chemically induced
Neutropenia / prevention & control*
Primary Prevention
Secondary Prevention
Survival Analysis
Treatment Outcome

Substances

Antineoplastic Agents
Hematologic Agents
Granulocyte Colony-Stimulating Factor