title: Chemotherapy treatment patterns and neutropenia management in gastric cancer.
abstract: BACKGROUND
  Potentially myelosuppressive doublet and triplet chemotherapy combination regimens are considered the most active treatments in gastric cancer. This multicenter prospective observational study was designed to gain insight into the chemotherapy regimens being used in Europe and to evaluate neutropenia management in patients identified as at high risk for febrile neutropenia (FN).
  
  
  METHODS
  Eligible patients had gastric cancer, were scheduled for ≥ 3 cycles of myelosuppressive chemotherapy, and had an investigator-assessed overall FN risk ≥ 20%. Data were collected for up to ten cycles. The primary endpoint was the proportion of patients who received granulocyte colony stimulating factor (G-CSF) primary prophylaxis (defined as G-CSF initiated on days 1-7 of cycle 1). Secondary endpoints included FN incidence, chemotherapy administration, and G-CSF use.
  
  
  RESULTS
  Of 199 patients who met the eligibility criteria and started at least one cycle of chemotherapy, mean age was 63 years, 76% were men, 83% had an ECOG score of 0 or 1, 54% had metastatic disease, and 24% had received prior chemotherapy. A total of 27 different backbone regimens were given; the most common regimen was modified docetaxel, cisplatin, and 5-fluorouracil (DCF). Despite all patients having been identified as having a ≥ 20% FN risk, only 70 (35%) received G-CSF primary prophylaxis. FN occurred in 14 patients overall (7%). Most FN events occurred in patients who received DCF/modified DCF (9/14 events, 64%).
  
  
  CONCLUSIONS
  The results of this study reveal a high use of myelotoxic treatment regimens in gastric cancer in Europe and low adherence to clinical practice guidelines for the use of primary and secondary G-CSF prophylaxis for FN.
authors.affiliation: Wojewodzki Szpital, Pabianicka 62, 93-513, Lodz, Poland, ewakalinka@wp.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kalinka-Warzocha
authors.forename: Javier Gallego
authors.initials: JG
authors.lastname: Plazas
authors.forename: Laurent
authors.initials: L
authors.lastname: Mineur
authors.forename: Tomas
authors.initials: T
authors.lastname: Salek
authors.forename: Alain
authors.initials: A
authors.lastname: Hendlisz
authors.forename: Lucy
authors.initials: L
authors.lastname: DeCosta
authors.forename: Florian D
authors.initials: FD
authors.lastname: Vogl
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Passalacqua
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced* / Q000188:drug therapy*; D011379:Prognosis; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: D016179:Granulocyte Colony-Stimulating Factor