C F Lee1,2, K Zhou3, W M Young4,5, C S Wong6, T Y Ng6, S F Lee6, K Leung5,7, L K M Wong5,8, K H So5,9, W Tang5,10, G Chong5,10, S K Chan11, Y T E Yip5,11, V Y M Ma5,12, A Yeung12, C H Y Chin12, M W Kwan8, H T Tsang8. 1. School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. jeff.travailler@gmail.com. 2. Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong. jeff.travailler@gmail.com. 3. School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. 4. Department of Pharmacy, Tuen Mun Hospital, Tuen Mun, Hong Kong. 5. COC Pharmaceutical Service - Oncology Working Group, Hospital Authority, Kowloon, Hong Kong. 6. Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong. 7. Department of Pharmacy, Queen Mary Hospital, Pok Fu Lam, Hong Kong. 8. Department of Pharmacy, Queen Elizabeth Hospital, Kowloon, Hong Kong. 9. Department of Pharmacy, Prince of Wales Hospital, Sha Tin, Hong Kong. 10. Department of Pharmacy, United Christian Hospital, Kwun Tong, Hong Kong. 11. Department of Pharmacy, Princess Margaret Hospital, Kwai Chung, Hong Kong. 12. Department of Pharmacy, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong.
Abstract
PURPOSE: To compare febrile neutropenia (FN) incidence and hospitalization among breast cancer patients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP. METHODS: We identified 3916 breast cancer patients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration. RESULTS: In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively. CONCLUSION: GCSF prophylaxis in breast cancer patients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.
PURPOSE: To compare febrile neutropenia (FN) incidence and hospitalization among breast cancerpatients on docetaxel with no granulocyte colony-stimulating factors (GCSF) primary prophylaxis (PP), 4/5-day PP, or 7-day PP. METHODS: We identified 3916 breast cancerpatients using docetaxel-cyclophosphamide (TC), doxorubicin-cyclophosphamide then docetaxel (AC-T), fluorouracil-epirubicin-cyclophosphamide then docetaxel (FEC-T), docetaxel-carboplatin-trastuzumab (TJH), or docetaxel-doxorubicin-cyclophosphamide (TAC) from a hospital pharmacy dispensing database in Hong Kong between 2014 and 2016. Patients were offered GCSF within 5 days since administering docetaxel. Outcomes included FN incidence, time to first hospitalization, hospitalization rate, and duration. RESULTS: In TC regimen, FN incidence (with odds ratio, OR) of patients with no PP, 4/5-day PP, and 7-day PP was 21.69%, 7.95% (OR 0.31, p < 0.001), and 5.33% (OR 0.20, p < 0.001), respectively. In TJH regimen, FN incidence of patients with no PP, 4/5-day PP, and 7-day PP was 38.26%, 8.33% (OR 0.15, p < 0.001), and 8.57% (OR 0.15, p < 0.001), respectively. FN incidence of patients on AC-T regimen with no PP and 4/5-day PP was 20.93% and 6.84%, respectively (OR 0.28, p = 0.005); with FEC-T regimen, the incidence was 9.91% and 4.77%, respectively (OR 0.46, p = 0.035). Only 3.27% FN cases were not hospitalized. Mean (±standard deviation, SD) time to first hospitalization was 8.21 ± 2.44 days. Mean (±SD) duration of hospitalization for patients with no PP, 4/5-day PP, and 7-day PP was 4.66 ± 2.60, 4.37 ± 2.85, and 5.12 ± 2.97 days, respectively. CONCLUSION: GCSF prophylaxis in breast cancerpatients on docetaxel could reduce FN incidence and hospitalization. 4/5-day PP demonstrated similar efficacy to 7-day PP with superior saving benefits on healthcare expenditure.
Entities:
Keywords:
Breast cancer; Docetaxel; Febrile neutropenia; GCSF; Hospitalization; Prophylaxis