title: Utilisation of primary and secondary G-CSF prophylaxis enables maintenance of optimal dose delivery of standard adjuvant chemotherapy for early breast cancer: an analysis of 1655 patients.
abstract: Optimal outcome for early breast cancer patients receiving adjuvant chemotherapy requires adequate dose delivery, commonly defined as >85% of planned dose of chemotherapy agents. Outside the clinical trial setting, reports from community oncology centres have demonstrated that a significant proportion of patients fail to receive this dose intensity, with neutropenia being the most commonly cited reason for sub-optimal treatment. Data collected prospectively on 1655 patient treated in a single breast cancer centre demonstrates that patients at risk of sub-optimal dose delivery can be identified by routine assessment of neutropenic events during the first cycle. The uniform administration of secondary G-CSF for all subsequent cycles enables dose delivery ≥85%, which was shown to lead to improved survival outcomes when compared with those patients who received <85%.
authors.affiliation: Curtin University, Western Australia 6000, Australia; Breast Cancer Research Centre-WA, Western Australia 6000, Australia. Electronic address: arlenechan@me.com.
authors.forename: Arlene
authors.initials: A
authors.lastname: Chan
authors.affiliation: Breast Cancer Research Centre-WA, Western Australia 6000, Australia.
authors.forename: Scott
authors.initials: S
authors.lastname: McGregor
authors.affiliation: National Drug Research Institute, Health Science, Curtin University, Western Australia 6000, Australia.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Liang
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006401:Hematologic Agents / Q000627:therapeutic use*; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control*; D011322:Primary Prevention; D055502:Secondary Prevention; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D006401:Hematologic Agents; D016179:Granulocyte Colony-Stimulating Factor
keywords: Breast cancer; First cycle nadir; G-CSF use; Relative dose intensity