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Bordoni RE, Haislip ST, Gilmore JW, Sharpe J, Abella E, Choi MR. P5-20-07: Estimation of Febrile Neutropenia in Women Receiving Docetaxel Plus Cyclophosphamide as Adjuvant Therapy for Early Stage Breast Cancer: A Retrospective Analysis. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-20-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: US Oncology Trial 9735 (Jones S, et al. JCO. 2006;24:5381–5387) established the docetaxel plus cyclophosphamide (TC) regimen as an effective adjuvant therapy for early stage breast cancer (ESBC). This trial did not specifically evaluate the incidence of febrile neutropenia (FN) as a study endpoint, but rates of 4%-8% were reported. Prophylactic granulocyte colony-stimulating factor (G-CSF) support was not allowed; reactive G-CSF support overall was not reported. Subsequent reports in the community setting have indicated FN rates of 25%-50% without G-CSF support and 0%-6.3% with G-CSF support (Table 1). To better determine the incidence of FN among ESBC patients treated with TC, we performed a retrospective clinical data review from the electronic medical record (EMR) database of Georgia Cancer Specialists, a large community oncology practice.
Methods: EMR data were captured between January 2006 and March 2010. Eligibility included women ≥ 18 years old with ESBC (stage I-IIIA) who completed ≥ 1 cycle of TC. The study time period was from the first dose of chemotherapy (CTX) to 6 weeks after the last dose of CTX, death, or loss to follow-up. The primary endpoint was the incidence of FN. Other endpoints included the incidence of severe (grade 3/4) neutropenia, neutropenia-related hospitalizations, G-CSF use, relative dose intensity (RDI), and dose delays and reductions. Results: Data from 662 patients were included in the analysis. Median age was 55 (range: 25–81) years. 40% of patients were white. The median number of CTX cycles received was 4 (range: 1–6). Most patients (91%) received G-CSF support; 73% as primary prophylaxis. See Table 2 for additional results.
Conclusions: This is the largest retrospective, community-based study to evaluate the incidence of FN in ESBC patients treated with TC. The observed FN rate of 5% (with 91% of patients receiving G-CSF) is consistent with other published reports using TC (Table 1). Our results suggest that TC is a taxane regimen with clinically significant myelosuppression (similar to other commonly used regimens in ESBC, such as TAC [NCCN Guidelines v2.2011]) and that the use of G-CSF support should always be considered.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-20-07.
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Affiliation(s)
- RE Bordoni
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - ST Haislip
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - JW Gilmore
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - J Sharpe
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - E Abella
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
| | - MR Choi
- 1Georgia Cancer Specialists, Marietta, GA; Amgen Inc., Thousand Oaks, CA
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Feinberg BA, Gilmore A, Lunacsek O, Haislip S, Yu E, Yim Y, Gilmore JW. Patient (Pt)-reported symptoms of chemotherapy (chemo) and VEGFR/EGFR antibody therapies for the treatment of metastatic colorectal cancer (MCRC) in a U.S. community-based oncology practice network. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
575 Background: Targeted therapies for MCRC have increased treatment (Tx) options in multiple therapy lines. Symptoms associated with MCRC Tx have not been well studied from the Pt perspective. Objective: To characterize symptoms reported by MCRC Pts treated with chemotherapy and/or targeted drugs at a large US oncology network. Methods: Pt reported symptom data were linked to electronic medical records and Pt charts from Georgia Cancer Specialists in Southeast US. MCRC Pts aged ≥18 years with ≥1 administration of chemo or targeted therapy between 1/2007-3/2009 were included. Pt reports captured 13 symptoms, onset, and severity. Due to small sample sizes, no statistical comparisons were conducted. Results: 332 MCRC Pts were included (median age 62 years, 47% male, median weight 74 kg, 48% ECOG PS 0 or 1). Amongst Pts receiving 1L Tx (n=299), 78% received bevacizumab (BV) +/- chemo, 4% cetuximab (CX) +/- chemo, 15% chemo only, and 2% other. 162 Pts received 2L Tx: 49% BV +/- chemo, 17% chemo only, 28% CX +/- chemo, and 6% other. The 5 most common symptoms in 1L Tx for all severity ratings were 36% fatigue, 20% nausea, 17% weight (wt) loss, 15% diarrhea, and 9% constipation. The 5 most common symptoms in all 2L Tx groups were 44% fatigue, 27% nausea, 19% diarrhea, 16% wt loss, and 11% abdomen pain. 2L moderate, severe, or disabling symptoms reported in >10% Pts receiving BV +/- chemo, CX +/- chemo, and chemo only Tx are shown in the table. Conclusions: The most commonly reported symptoms by 1L and 2L MCRC Pts were fatigue, nausea, diarrhea, and weight loss. Overall, a numerically higher % of 2L Pts treated with CX +/- chemo reported moderate, severe, and disabling symptoms than Pts receiving BV +/- chemo and chemo alone. Rash was not observed in the BV +/- chemo group. Further research of MCRC Pt reported symptoms in a larger sample size are warranted. [Table: see text] [Table: see text]
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Affiliation(s)
- B. A. Feinberg
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
| | - A. Gilmore
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
| | - O. Lunacsek
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
| | - S. Haislip
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
| | - E. Yu
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
| | - Y. Yim
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
| | - J. W. Gilmore
- Georgia Cancer Specialists PC, Atlanta, GA; Xcenda, LLC, Palm Harbor, FL; Genentech, South San Francisco, CA
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Feinberg BA, Chen L, Zhao L, Gilmore JW, Haislip S, Saleh MN, Sullivan SD, Christiansen NP. Association of black race and outcomes in patients with nonmetastatic triple-negative breast cancer (TNBC): Results from a U.S. local oncology practice. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gilmore JW, Feinberg BA, Wisniewski T, Haislip S, Wentworth C, Burke TA. Risk factors for nausea and vomiting (NV) following highly or moderately emetogenic chemotherapy (HEC or MEC) in U.S. community oncology practice. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Zhao L, Seal BS, Feinberg BA, Gilmore JW, Haislip S, Sullivan SD, Christiansen NP. Cancer recurrence and survival in patients with early-stage triple-negative breast cancer in a U.S. local oncology practice. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Volas-Redd GH, Chen L, Zhao L, Feinberg BA, Gilmore JW, Haislip S, Sullivan SD, Christiansen NP. Taxane use and neuropathy in early-stage breast cancer patients: Results from a U.S. community oncology center. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e16522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Feinberg BA, Gilmore JW, Saleh MN, Gondesen T, Jackson J, Barghout V, Mody-Patel N. Zoledronic acid compliance and persistency in bone metastases due to breast, lung, and prostate cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.17513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Gilmore JW, Carleton MA, Harris FS, Smith RE, Heald FD, Leclerc LA, Webster FM. Interstate Conference on Cereal Investigations. Science 1915; 41:602-3. [PMID: 17740901 DOI: 10.1126/science.41.1060.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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