Clinical Outcomes of Secondary Prophylactic Granulocyte Colony-Stimulating Factors in Breast Cancer Patients at a Risk of Neutropenia with Doxorubicin and Cyclophosphamide-Based Chemotherapy
- 주제(키워드) secondary prophylaxis , granulocyte colony-stimulating factor , breast cancer , neutropenia , adjuvant chemotherapy , doxorubicin , cyclophosphamide
- 주제(기타) Chemistry, Medicinal
- 주제(기타) Pharmacology & Pharmacy
- 설명문(일반) [Choi, Jae Hee; Rhie, Sandy Jeong] Ewha Womans Univ, Div Life & Pharmaceut Sci Grad Sch, Seoul 03760, South Korea; [Choi, Jae Hee; Oh, Yun Kyoung] Konkuk Univ Med Ctr, Dept Pharm, Seoul 05030, South Korea; [Geum, Min Jung] Ewha Womans Univ, Grad Sch Clin Biohealth, Seoul 03760, South Korea; [Geum, Min Jung] Yonsei Univ Hlth Syst, Severance Hosp, Dept Pharm, Seoul 03722, South Korea; [Kang, Ji Eun; Rhie, Sandy Jeong] Ewha Womans Univ, Coll Pharm, Seoul 03760, South Korea; [Kang, Ji Eun] Natl Med Ctr, Dept Pharm, Seoul 04564, South Korea; [Park, Nam Gi; Rhie, Sandy Jeong] Ewha Womans Univ, Grad Sch Pharmaceut Sci, Seoul 03760, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 MDPI
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190431
- 본문언어 영어
- Published As https://doi.org/10.3390/ph14111200
- PubMed https://pubmed.ncbi.nlm.nih.gov/34832982
초록/요약
Doxorubicin and cyclophosphamide (AC)-based chemotherapy has been a standard regimen for early-stage breast cancer (ESBC) with an intermediate risk (10-20%) of febrile neutropenia (FN). Secondary prophylaxis of granulocyte colony-stimulating factor (G-CSF) is considered in patients receiving AC-based chemotherapy; however, relevant studies are limited. Here, we retrospectively reviewed the electronic medical records of 320 patients who completed adjuvant AC-based chemotherapy from September 2016 to September 2020. Approximately 46.6% of the patients developed severe neutropenic events (SNE) during AC-based chemotherapy. Secondary prophylaxis of G-CSF reduced the risk of recurrent SNE (p < 0.01) and the relative dose intensity (RDI) < 85% (p = 0.03) in patients who had experienced SNE during AC-based chemotherapy. Age & GE; 65 years (p = 0.02) and alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 60 IU/L (p = 0.04) were significant risk factors for RDI < 85%. The incidences of FN, grade 4 neutropenia, unscheduled hospitalization, and interruption to the dosing regimen were reduced in patients administered secondary prophylaxis with G-CSF (before vs. after administration: FN, 19.4% vs. 4.6%; grade 4 neutropenia, 86.1% vs. 14.8%; unscheduled hospitalization, 75.9% vs. 11.1%; interruption to the dosing regimen, 18.5% vs. 8.3%). This study indicated the importance of active intervention of G-CSF use to prevent recurrent SNE and improve clinical outcomes in patients with breast cancer who receive AC-based chemotherapy.
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