The impact of new European Organisation for Research and Treatment of Cancer guidelines on the use of granulocyte colony-stimulating factor on the management of breast cancer patients.
Febrile neutropenia (FN) is a severe consequence of myelosuppressive therapy. The European Organisation for Research and Treatment of Cancer recently published guidelines on the use of granulocyte colony-stimulating factor (G-CSF) to prevent FN in patients with malignant disease. In this review, the impact of these guidelines on breast cancer treatment is discussed. A brief summary of FN in breast cancer is given, and patient-related and treatment schedule-related risk factors for FN are reviewed for the adjuvant/neoadjuvant and metastatic disease settings. Primary G-CSF support is recommended if the overall FN risk is > or = 20%, or if a reduction in dose-intensity is associated with a poorer outcome. Any formulation of G-CSF is recommended. The utility of G-CSF in reducing the incidence of FN and enabling treatment regimens is discussed.
Zielinski
Christoph C
CC
Department of Medicine I and Clinical Division of Oncology, Medical University Vienna and Central European Cooperative Oncology Group (CECOG), Waehringer Guertel 18-20, A-1090 Vienna, Austria. christoph.zielinski@meduniwien.ac.at
Awada
Ahmad
A
Cameron
David A
DA
Cufer
Tanja
T
Martin
Miguel
M
Aapro
Matti
M
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D019317:Evidence-Based Medicine; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor