G-CSF use and neutropenic events in patients with breast and lung tumours: data from routine clinical practice (IMPACT Solid study)

Konference: 2009 34st Congress ESMO a 15th Congress ECCO - účast ČR

Kategorie: Zhoubné nádory prsu

Téma: Poster Session IV: Symptom science

Číslo abstraktu: P-3036

Autoři: K. Krzemieniecki; F.L.G. Erdkamp; H. Lindman; J. Maenpaa; J. Puertas; M. Schwenkglenks; P. Sevelda; MUDr. Martin Šmakal; I. Varthalitis; S. Verma

Background: EORTC guidelines recommend primary prophylaxis with granulocyte colony stimulating factors (G-CSFs) for cancer patients at high overall (≥20%) risk of febrile neutropenia (FN) due to chemotherapy (CT) and other risk factors, as well as to support dose dense regimens. We aim to assess G-CSF prophylaxis in clinical practice and its impact on neutropenic events and CT delivery.

Methods: This prospective, observational study (Clinicaltrials.gov: NCT00883181), is planned to include ∼1300 patients with solid tumours (breast cancer, non-small cell lung cancer [NSCLC], small cell lung cancer [SCLC] and ovarian cancer) receiving any myelotoxic CT, who are judged to be at ≥20% risk of FN per EORTC guidelines. The primary outcome measure is the incidence of FN in relation to G-CSF use.

Results: This descriptive interim analysis includes 202 patients recruited from Dec 2007, who completed CT by Dec 2008. The most common CT regimens in breast cancer were docetaxel (Doc)/doxorubicin (A)/cyclo­phosphamide (C) (22%), fluoro­uracil (F)/epirubicin (E)/C–Doc (18%) and A or E/Doc (17%), as was cisplatin + etoposide or vinorelbine in lung cancer (46%). G-CSF prophylaxis and FN events are shown below (see table).

Conclusions: This interim analysis suggests that many breast cancer patients considered at high FN risk are receiving aggressive adjuvant CT, often with G-CSF primary prophylaxis. The low proportion of elderly breast cancer patients suggests that few receive aggressive CT. Lung cancer patients may be at high FN risk due to older age and advanced disease. G-CSF primary prophylaxis was less common in this group, where FN and CT dose reductions were more frequent. Guidelines on G-CSF use may not be routinely applied in the non-curative setting. This ongoing study will help to better describe neutropenia management in clinical practice.

Publikováno v: European Journal of Cancer Supplements, Vol 7 No 2, September 2009, Page 186

Datum přednesení příspěvku: 22. 9. 2009