The use of granulocyte colony stimulating factor (G-CSF) and management of chemotherapy delivery during adjuvant treatment for early-stage breast cancer-Further observations from the IMPACT solid study
2016 (English)In: Breast, ISSN 0960-9776, E-ISSN 1532-3080, Vol. 25, 27-33 p.Article in journal (Refereed) PublishedText
Objective: To investigate the use and impact of granulocyte colony-stimulating factors (G-CSF) on chemotherapy delivery and neutropenia management in breast cancer in a clinical practice setting. Methods: IMPACT Solid was an international, prospective observational study in patients with a physician-assessed febrile neutropenia (FN) risk of >= 20%. This analysis focused on stages I-III breast cancer patients who received a standard chemotherapy regimen for which the FN risk was published. Chemotherapy delivery and neutropenia-related outcomes were reported according to the FN risk of the regimen and intent of G-CSF use. Results: 690 patients received a standard chemotherapy regimen; 483 received the textbook dose/schedule with a majority of these regimens (84%) having a FN risk >= 10%. Patients receiving a regimen with a FN risk >= 10% were younger with better performance status than those receiving a regimen with a FN risk < 10%. Patients who received higher-risk regimens were more likely to receive G-CSF primary prophylaxis (48% vs 22%), complete their planned chemotherapy (97% vs 88%) and achieve relative dose intensity >= 85% (93% vs 86%) than those receiving lower-risk regimens. Most first FN events (56%) occurred in cycles not supported with G-CSF primary prophylaxis. Conclusion: Physicians generally recommend standard adjuvant chemotherapy regimens and were more likely to follow G-CSF guidelines for younger, good performance status patients in the curative setting, and often modify standard regimens in more compromised patients. However, G-CSF support is not optimal, indicated by G-CSF primary prophylaxis use in < 50% of high-risk patients and observation of FN without G-CSF support.
Place, publisher, year, edition, pages
2016. Vol. 25, 27-33 p.
Granulocyte colony-stimulating factor, Neutropenia, Chemotherapy delivery, Clinical practice
Cancer and Oncology
IdentifiersURN: urn:nbn:se:uu:diva-277777DOI: 10.1016/j.breast.2015.11.007ISI: 000368373500004PubMedID: 26801413OAI: oai:DiVA.org:uu-277777DiVA: diva2:905823