Frequency of febrile neutropenia in breast cancer patients receiving epirubicin and docetaxel/paclitaxel with colony-stimulating growth factors: a comparison of filgrastim or lenograstim with pegfilgrastim.
OBJECTIVE
Recombinant granulocyte colony-stimulating factors (G-CSF) have been shown to be effective in reducing the risk of infections associated with antitumour chemotherapy. This report describes a single-centre experience of the efficacy of pegfilgrastim compared with filgrastim or lenograstim in reducing the incidence of febrile neutropenia in patients receiving combination chemotherapy with taxane and epirubicin in a neoadjuvant and adjuvant setting.


METHODS
A total of 118 patients with breast cancer were treated with either epirubicin 75 mg/m(2) and docetaxel 75 mg/m(2) or epirubicin 90 mg/m(2) and paclitaxel 200 mg/m(2) every 3 weeks; 88 received G-CSF support with daily filgrastim or lenograstim and 30 with pegfilgrastim once per cycle.


RESULTS
Eight patients (9.1%) with prophylactic filgrastim or lenograstim support developed febrile neutropenia, as well as 1 patient (3.3%) in the pegfilgrastim group (p = 0.445). Febrile neutropenia occurred in 13 (2.7%) of 476 filgrastim or lenograstim supported chemotherapy cycles and in 2 (1.2%) of 172 cycles with pegfilgrastim support (p = 0.376). The frequency of chemotherapy delays and dose reductions was not significantly different between the two G-CSF treatment groups.


CONCLUSIONS
These data show a trend towards superiority of pegfilgrastim over filgrastim or lenograstim in reducing the frequency of febrile neutropenia in patients treated with taxane and epirubicin chemotherapy regimens for breast cancer.
Schippinger
Walter
W
Division of Medical Oncology, Department of Internal Medicine, Medical University Graz, Graz, Austria. walter.schippinger@klinikum-graz.at
Holub
Robert
R
Dandachi
Nadia
N
Bauernhofer
Thomas
T
Samonigg
Hellmut
H
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003115:Colony-Stimulating Factors / Q000627:therapeutic use*; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000517:prevention & control; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D000078224:Lenograstim; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D017239:Paclitaxel / Q000008:administration & dosage; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000627:therapeutic use; D043823:Taxoids / Q000008:administration & dosage
D003115:Colony-Stimulating Factors; D011994:Recombinant Proteins; D043823:Taxoids; D016179:Granulocyte Colony-Stimulating Factor; D000077143:Docetaxel; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D015251:Epirubicin; D000078224:Lenograstim; D017239:Paclitaxel; D000069585:Filgrastim