Florence Van Ryckeghem1, Chloë Haverbeke2, Wim Wynendaele3, Guy Jerusalem4, Luc Somers5, Anke Van den Broeck6, Sofie Vingerhoedt6, Simon Van Belle7. 1. AZ Glorieux, Ronse, Belgium and Gent University Hospital, Ghent, Belgium. 2. Gent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. 3. Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium. 4. CHU Sart Tilman Liège and University of Liège, Liège, Belgium. 5. OncoLogX, Antwerp, Belgium. 6. Amgen, Brussels, Belgium. 7. Gent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. simon.vanbelle@ugent.be.
Abstract
PURPOSE: To prevent febrile neutropenia (FN), European Organisation for Research and Treatment of Cancer (EORTC) guidelines recommend primary prophylaxis with granulocyte colony-stimulating factors (PPG) for patients at high risk (≥ 20%) of FN. In Belgium, the use of PPG is restricted by specific reimbursement criteria. The impact of these criteria on PPG use and adherence to guidelines is unknown. METHODS: This multicentre, cross-sectional, observational study aimed to describe PPG use by FN risk category in breast cancer patients who were scheduled to receive myelosuppressive chemotherapy in outpatient clinics in Belgium during a 2-week period between 13 October and 12 December 2014. RESULTS: In total, 490 patients were enrolled. Median age was 57.0 years. Based on their chemotherapy regimen, 53.9, 5.1 and 41.0% of patients were at a low, intermediate and high risk of FN, respectively. Overall, 39.8% of patients received PPG (17.0, 12.0 and 73.1% of those receiving low-, intermediate- and high-risk regimens, respectively). In the high-risk category, PPG was used in 89.9% of dose-dense and in 25.0% of classical chemotherapy regimens. PPG use was adherent to EORTC guidelines in 75.3% of patients (30.6% appropriate use, 44.7% appropriate non-use). EORTC guidelines would recommend PPG use in 46.1% of this study population (n = 226), and its use was reimbursable in Belgium in 76.1% of these patients (n = 172), but only 66.4% of them received PPG (n = 150). CONCLUSIONS: Both Belgian reimbursement criteria and physician decision-making led to a proportion of patients for whom PPG treatment was recommended but finally not receiving it.
PURPOSE: To prevent febrile neutropenia (FN), European Organisation for Research and Treatment of Cancer (EORTC) guidelines recommend primary prophylaxis with granulocyte colony-stimulating factors (PPG) for patients at high risk (≥ 20%) of FN. In Belgium, the use of PPG is restricted by specific reimbursement criteria. The impact of these criteria on PPG use and adherence to guidelines is unknown. METHODS: This multicentre, cross-sectional, observational study aimed to describe PPG use by FN risk category in breast cancerpatients who were scheduled to receive myelosuppressive chemotherapy in outpatient clinics in Belgium during a 2-week period between 13 October and 12 December 2014. RESULTS: In total, 490 patients were enrolled. Median age was 57.0 years. Based on their chemotherapy regimen, 53.9, 5.1 and 41.0% of patients were at a low, intermediate and high risk of FN, respectively. Overall, 39.8% of patients received PPG (17.0, 12.0 and 73.1% of those receiving low-, intermediate- and high-risk regimens, respectively). In the high-risk category, PPG was used in 89.9% of dose-dense and in 25.0% of classical chemotherapy regimens. PPG use was adherent to EORTC guidelines in 75.3% of patients (30.6% appropriate use, 44.7% appropriate non-use). EORTC guidelines would recommend PPG use in 46.1% of this study population (n = 226), and its use was reimbursable in Belgium in 76.1% of these patients (n = 172), but only 66.4% of them received PPG (n = 150). CONCLUSIONS: Both Belgian reimbursement criteria and physician decision-making led to a proportion of patients for whom PPG treatment was recommended but finally not receiving it.
Entities:
Keywords:
Breast cancer; Chemotherapy; Febrile neutropenia; Granulocyte colony-stimulating factor; Prophylaxis
Authors: Mikko S Venäläinen; Eetu Heervä; Outi Hirvonen; Sohrab Saraei; Tomi Suomi; Toni Mikkola; Maarit Bärlund; Sirkku Jyrkkiö; Tarja Laitinen; Laura L Elo Journal: Cancer Med Date: 2021-12-03 Impact factor: 4.452
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