title: Risk and Consequences of Chemotherapy-Induced Febrile Neutropenia in Patients With Metastatic Solid Tumors.
abstract: Although studies have evaluated the risk and consequences of febrile neutropenia (FN) among patients receiving cancer chemotherapy in US clinical practice, none have focused on a broad group of patients with metastatic disease.
  
  
  
  A retrospective cohort design and health care claims (2006 to 2011) from private health plans covering a geographically diverse US population of > 30 million persons annually were used. The study population included adults who underwent myelosuppressive chemotherapy for metastatic cancer of the breast (MBC), colon/rectum (MCRC), lung (MLC), ovaries (MOC), or prostate (MPC). For each patient, the first chemotherapy course and each cycle therein, along with each episode of FN and the consequences thereof, were identified.
  
  
  
  The most common regimens, by cancer type, were paclitaxel (18% of 15,318 patients with MBC); oxaliplatin, fluorouracil, and leucovorin (23% of 16,923 patients with MCRC); carboplatin plus paclitaxel (23% of 21,999 patients with MLC); carboplatin plus paclitaxel (49% of 7,433 patients with MOC); and docetaxel (68% of 4,667 patients with MPC). Across cancers, FN occurred in 13.1% to 20.6% of patients during their chemotherapy course, most often required hospitalization (89% to 94%), and most often occurred in the first cycle (23% to 36%). Among hospitalized patients with FN, mean length of stay ranged from 7.0 to 7.5 days, and inpatient mortality ranged from 3.9% to 10.3%; mean FN-related costs during the cycle ranged from $16,291 to $19,456.
  
  
  
  Among patients receiving myelosuppressive chemotherapy for metastatic cancer in US clinical practice, FN is a frequent complication, associated with significant morbidity, mortality, and economic costs, and should be given careful consideration in the treatment of this population.
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA dweycker@pai2.com.
authors.forename: Derek
authors.initials: D
authors.lastname: Weycker
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Li
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: John
authors.initials: J
authors.lastname: Edelsberg
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Rich
authors.initials: R
authors.lastname: Barron
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Alex
authors.initials: A
authors.lastname: Kartashov
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Hairong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Policy Analysis (PAI), Brookline, MA; Amgen, Thousand Oaks, CA; and Hutchinson Cancer Research Center, Seattle, WA.
authors.forename: Gary H
authors.initials: GH
authors.lastname: Lyman
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000191:economics* / Q000209:etiology* / Q000401:mortality; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors