Comparison of filgrastim and pegfilgrastim to prevent neutropenia and maintain dose intensity of adjuvant chemotherapy in patients with breast cancer
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The aim of this study was to compare the effectiveness of prophylactic single fixed dose of pegfilgrastim and daily administration of filgrastim on febrile neutropenia (FN), severe neutropenia, treatment delay, and dose reduction in patients with breast cancer receiving dose-dense adjuvant chemotherapy.
A retrospective cohort study with 1058 breast cancer patients matched by age and chemotherapy was conducted. The primary endpoints were FN, severe (grade 3, 4) neutropenia, dose reduction (>10 % reduction of the dose planned), and treatment delay (dose given more than 2 days later).
Eighteen episodes of FN (3.4 %) in the filgrastim group and 23 (4.3 %) in the pegfilgrastim group (p = 0.500) were recorded. More than half of the total episodes (27/41) occurred during the first 4 cycles of treatment. Patients who received filgrastim were almost three times more likely to experience a severe neutropenia episode and were significantly more likely to experience a dose reduction (18.5 %) compared to those who received pegfilgrastim (10.8 %) (p < 0.001). The percentage of patients, who received their planned dose on time, was significantly lower in patients receiving filgrastim (58 %) compared to those receiving pegfilgrastim (72.4 %, p < 0.001).
No significant difference was detected on FN rate between daily administration of filgrastim and single administration of pegfilgrastim. However, patients receiving pegfilgrastim had a significantly lower rate of severe neutropenia, as well as dose reduction and treatment delay, thus, achieving a higher dose density.
KeywordsBreast cancer Dose-dense chemotherapy Greece Neulasta Neutropenia
The authors wish to thank all Hellenic Cooperative Oncology Group coordinators for data collection, Ms. E. Fragou for study monitoring, Ms. M. Moschoni for data management, and Mw. N. Sotiriadou for secretarial assistance.
Conflict of interest
There is no conflict of interest.
- 14.von Minckwitz G, Schwenkglenks M, Skacel T et al (2009) Febrile neutropenia and related complications in breast cancer patients receiving pegfilgrastim primary prophylaxis versus current practice neutropaenia management: results from an integrated analysis. Eur J Cancer 45:608–617Google Scholar
- 16.Fountzilas G, Dafni U, Gogas H et al (2008) Postoperative dose-dense sequential chemotherapy with epirubicin, paclitaxel and CMF in patients with high-risk breast cancer: safety analysis of the Hellenic Cooperative Oncology Group randomized phase III trial HE 10/00. Ann Oncol 19:853–860PubMedGoogle Scholar
- 18.Skarlos DV, Timotheadou E, Galani E et al (2009) Pegfilgrastim administered on the same day with dose-dense adjuvant chemotherapy for breast cancer is associated with a higher incidence of febrile neutropenia as compared to conventional growth factor support: matched case-control study of the Hellenic Cooperative Oncology Group. Oncology 77:107–112CrossRefPubMedGoogle Scholar