Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Risk of Treatment Related Death and Febrile Neutropaenia with Taxane-Based Adjuvant Chemotherapy for Breast Cancer in a Middle Income Country Outside a Clinical Trial Setting

  • Phua, Chee Ee (Clinical Oncology Unit) ;
  • Bustam, Anita Zarina (Clinical Oncology Unit) ;
  • Yusof, Mastura Md. (Clinical Oncology Unit) ;
  • Saad, Marniza (Clinical Oncology Unit) ;
  • Yip, Cheng-Har (Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur) ;
  • Taib, Nor Aishah (Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur) ;
  • Ng, Char Hong (Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur) ;
  • Teh, Yew Ching (Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur)
  • Published : 2012.09.30
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Abstract

Background: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane-based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$. Results: A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

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References

  1. Aapro MS, Bohlius J, Cameron DA, et al (2011). 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy -induced febrile neutropaenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer, 47, 8-32.
  2. Aapro MS, Cameron DA, Pettengell, et al (2006). EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropaenia in adult patients with lymphomas and solid tumours. Eur J Cancer, 42, 2433-53. https://doi.org/10.1016/j.ejca.2006.05.002
  3. Crawford J, Dale D, Lyman G (2004). Chemotherapy-induced neutropaenia. Risks, consequences and new directions for its management. Cancer, 100, 228-37. https://doi.org/10.1002/cncr.11882
  4. Dale DC (2002). Colony-stimulating factors for the management of neutropaenia in cancer patients. Drugs, 62, 1-15.
  5. de Naurois J, Novitzky-Basso I, Gill MJ, et al (2010). Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of Oncology, 21, 252-6. https://doi.org/10.1093/annonc/mdq196
  6. Early Breast Cancer Trialists' Collaborative Group (EBCTCG) (2005). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomized trials. Lancet, 365, 1687-717 https://doi.org/10.1016/S0140-6736(05)66544-0
  7. Ellis P, Barrett-Lee P, Johnson L, et al (2009). Sequential docetaxel as adjuvant chemotherapy for early breast cancer (TACT): an open label, phase III, randomized controlled trial. Lancet, 373, 1681-92. https://doi.org/10.1016/S0140-6736(09)60740-6
  8. Ferguson T, Wilcken N, Vagg R, et al (2010). Taxanes for adjuvant treatment of early breast cancer (Review). The Cochrane Cochrane Library, Issue 10.
  9. Greil R, Psenak O (2007). Hematopoietic growth factors: ESMO recommendations for the application. Ann Oncol, 18, 89-91.
  10. Henderson IC, Berry DA, Demetri GD, et al (2003). Improved outcomes from adding sequential paclitaxel but not from escalating doxorubicin dose in an adjuvant chemotherapy regimen for patients with node-positive primary breast cancer. J Clin Oncol, 21, 976-83. https://doi.org/10.1200/JCO.2003.02.063
  11. Jones S, Holmes FA, O'Shaughnessy J, et al (2009). Docetaxel with cyclophosphamide is associated with an overall survival benefit compared with doxorubicin and cyclophosphamide: 7-year follow-up of US Oncology Research Trial 9735. J Clin Oncol, 27, 1177-83. https://doi.org/10.1200/JCO.2008.18.4028
  12. Klastersky J, Awada A, Paesmans M, et al (2011). Febrile neutropaenia: A critical review of the initial management. Critical Reviews in Oncology/Hematology, 78, 185-94. https://doi.org/10.1016/j.critrevonc.2010.03.008
  13. Kuderer NM, Dale DC, Crawford J, et al (2007). Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropaenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol, 25, 3158-67. https://doi.org/10.1200/JCO.2006.08.8823
  14. Lyman GH, Kuderer NM, Djulbegovic B (2002). Prophylactic granulocyte colony-stimulating factor in patients receiving dose-intensive cancer chemotherapy: meta-analysis. Am J Med, 112, 406-11. https://doi.org/10.1016/S0002-9343(02)01036-7
  15. Madarnas Y, Dent SF, Husain SF, et al (2011). Real world experience with adjuvant FEC_D chemotherapy in four Ontario regional cancer centers. Current Oncology, 18, 119-25.
  16. Mamounas EP, Bryant J, Lembersky B, et al (2005). Paclitaxel after doxorubicin plus cyclophosphamide as adjuvant chemotherapy for node-positive breast cancer: results from NSABP-28. J Clin Oncol, 23, 3686-96. https://doi.org/10.1200/JCO.2005.10.517
  17. Martin M, Pienkowski T, Mackey J, et al (2005). Adjuvant Docetaxel for node positive breast cancer. N Engl J Med, 352, 2302-13. https://doi.org/10.1056/NEJMoa043681
  18. National Comprehensive Cancer Network (2009). Myeloid growth factors. http://www.nccn.org/
  19. Phua CE, Bustam AZ, Yusof MM, et al (2012). Risk of treatment related death (TRD) with adjuvant chemotherapy for breast cancer: A study in University Malaya Medical Centre (UMMC). J Cancer Therapeutics and Res, 1, 13. https://doi.org/10.7243/2049-7962-1-13
  20. Smith TJ, Khatcheressian J, Lyman JH, et al (2006). Update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol, 24, 3187-205. https://doi.org/10.1200/JCO.2006.06.4451
  21. Srokowski TP, Fang S, Hortobagyi GN, et al (2009). Impact of diabetes mellitus on complications and outcomes of adjuvant chemotherapy in older patients with breast cancer. J Clin Oncol, 27, 2170-6. https://doi.org/10.1200/JCO.2008.17.5935

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