Other research activities of INC-EU study group members
Two recent reports describe the impact of reduced RDI on survival in lymphoma patients receiving CHOP-21 chemotherapy in the UK1 and Belgium2. Both studies found that patient survival was reduced when RDI was ≤ 90%, indicating that patient outcome is improved when the intensity of chemotherapy treatment is optimal.
A recent audit by the South West London Cancer Network (communicated by Robert Leonard) recorded 71 hospital admissions for FN3. In 51 patients, this was the first episode of FN. The most frequent chemotherapy regimens in these patients hospitalised for FN were CHOP, docetaxel, AC and FEC, and most episodes of FN occurred during the first two cycles. Mean time from arrival to start of antibiotic therapy was 2.6 hours and patients were hospitalised for a median of 5 days. Chemotherapy was delayed in 26% of patients and reduced in 19%. Four patients (5.6%) died during admission. Other studies have reported mortality rates of 9.5%4 and 12%5 in patients hospitalised for FN. FN still poses a significant risk of morbidity and mortality.
A retrospective sub-analysis of results from the GEPARTRIO study compared the efficacy of four primary prophylaxis regimens against FN and related toxicities in 1,256 breast cancer patients who received TAC neoadjuvant chemotherapy6. Primary prophylaxis was intensified by stepwise protocol amendments resulting in four patient cohorts: ciprofloxacin, daily CSF, pegfilgrastim, pegfilgrastim and ciprofloxacin. Pegfilgrastim ± ciprofloxacin was significantly more effective than either ciprofloxacin or six doses of daily CSF in preventing FN and reducing neutropenia-related hospitalisations. Daily CSF was significantly more effective than ciprofloxacin alone in reducing neutropenia-related hospitalisations.
Bibliography
1. Pettengell R, et al. Ann. Hematol. 2008; 87(5):429.
2. Bosly A, et al. Ann. Hematol. 2008; 87(4):277.
3. Dernedde U, et al. J. Clin. Oncol. 2008; 26s: Abstract 20653.
4. Kuderer NM, et al. Cancer. 2006; 106(10):2258.
5. Courtney DM, et al. Oncologist. 2007; 12(8):1019.
6. von Minckwitz G, et al. Ann. Oncol. 2008;19(2):292.