Impact of Primary Pegfilgrastim Prophylaxis on Relative Dose Intensity in Neoadjuvant/Adjuvant FEC-100 Chemotherapy

Anticancer Res. 2020 Feb;40(2):915-921. doi: 10.21873/anticanres.14024.

Abstract

Background/aim: This study aimed was to clarify the impact of pegfilgrastim (PEG) 3.6 mg primary prophylaxis of febrile neutropenia (FN) on the average relative dose intensity (ARDI) of neoadjuvant/adjuvant FEC-100 for breast cancer.

Materials and methods: This retrospective, single-centre cohort study including 296 patients who received FEC-100 compared PEG and non-PEG groups. The PEG group received PEG 3.6 mg as a single subcutaneous injection in each study cycle. The primary endpoint was the ARDI of FEC-100. The secondary endpoints were patient percentage of ARDI≥85%, factors associated with ARDI≥85%, and reasons for reduced ARDI.

Results: The PEG group showed significantly higher mean ARDI (95.6% versus 90.7%, p<0.001) and patient percentage of ARDI≥85% (93.0% versus 79.9%, p=0.001). PEG was significantly associated with ARDI≥85% (p=0.009). Neutropenia and FN, the main reasons for reduced ARDI, were significantly lower in the PEG group (p<0.05).

Conclusion: Primary PEG 3.6 mg prophylaxis increased the ARDI of FEC-100.

Keywords: FEC-100; Pegfilgrastim; breast cancer; febrile neutropenia; relative dose intensity.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cohort Studies
  • Cyclophosphamide / pharmacology
  • Cyclophosphamide / therapeutic use
  • Epirubicin / pharmacology
  • Epirubicin / therapeutic use
  • Female
  • Filgrastim / pharmacology
  • Filgrastim / therapeutic use*
  • Fluorouracil / pharmacology
  • Fluorouracil / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Polyethylene Glycols / pharmacology
  • Polyethylene Glycols / therapeutic use*
  • Retrospective Studies

Substances

  • pegfilgrastim
  • Polyethylene Glycols
  • Epirubicin
  • Cyclophosphamide
  • Filgrastim
  • Fluorouracil

Supplementary concepts

  • FEC protocol