title: Cefepime monotherapy for febrile neutropenia in patients with lung cancer.
abstract: We assessed the efficacy and safety of cefepime monotherapy (1 g intravenously every 8 h) for febrile neutropenia in patients with lung cancer in a multi-institutional phase II study. Patients treated with chemotherapy with or without radiotherapy for lung cancer were eligible for this study. Other eligibility criteria included fever (temperature of ≥38.0 °C) and an absolute neutrophil count of <500/mm(3) or <1000/mm(3) with an expected decline to <500/mm(3) within the next 48 h. Risk assessment was performed using the Multinational Association of Supportive Care in Cancer risk-index score. Cefepime 1 g was given intravenously every 8 h. The primary endpoint was the response rate at the end of cefepime therapy. Co-administration of granulocyte-colony-stimulating factor was permitted. Of 54 patients enrolled, 39 were classified in the low-risk group and 15 in the high-risk group. Overall response rate was 78% (95% CI: 64.4-88.0%). The response rates were 85% (95% CI: 69.5-94.1%) in the low-risk group and 60% (95% CI: 32.3-83.7%) in the high-risk group, respectively. One patient died from septic shock due to Enterobacter cloacae bacteremia. There was no significant adverse event. Cefepime 1 g intravenously every 8 h appears to be effective for febrile neutropenia in patients with lung cancer, especially in those with low-risk febrile neutropenia, and is well tolerated.
  
  
  BACKGROUND
  UMIN Clinical Trials Registry, UMIN000006157.
authors.affiliation: Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan. Electronic address: hsaito@acc-aichi.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
authors.affiliation: Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
authors.forename: Motoyasu
authors.initials: M
authors.lastname: Okuno
authors.affiliation: Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Saka
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Imaizumi
authors.affiliation: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Respiratory Medicine, Toyota Kosei Hospital, Toyota, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Tanikawa
authors.affiliation: Department of Respiratory Medicine, Nagoya Ekisaikai Hospital, Nagoya, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan.
authors.forename: Joe
authors.initials: J
authors.lastname: Shindoh
authors.affiliation: Division of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan.
authors.forename: Ryujiro
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Biomedical Sciences, Chubu University, Kasugai, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Shimokata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D002511:Cephalosporins; D000077723:Cefepime
keywords: Cefepime; Chemotherapy; Febrile neutropenia; Lung cancer