Abstract
Abstract
Background: Febrile neutropenia (FN) is one of the most significant toxicities experienced by patients treated with systemic therapy. Taxanes now play an integral role in the systemic therapy for women with early stage breast cancer. The most common taxane-containing regimen utilized in Ontario, Canada is 5-Fluorouracil/Epirubicin/Cyclophosphamide x 3 followed by Docetaxel x 3 (FEC-D). PACS 01 reported a febrile neutropenia (FN) rate of 11.2% in the FEC-D arm. In our clinical practice, clinicians have noted a much higher rate of FN. We report the FN rate with the use of FEC-D in women with early stage breast cancer treated at tertiary care centers in Ontario.Methods: All women with early stage breast cancer who were treated with FEC-D from three tertiary care cancer centers in Ontario, Canada (London, Sudbury, Ottawa) between June 2006 and December 2008 were included in this retrospective analysis. Data included: demographics, staging, hormone receptor status, primary prophylaxis use with growth factors, FN rate, admission to hospital and duration of hospital admission.Results: Median age of 630 women is 52 years (r: 24-77). Staging was: I (88), IIA (243), IIB (159), IIIA (94), IIIB (23), IIIC (14) and 9 unknown. A total of 474 (75.2%) were ER positive. Primary prophylaxis with growth factor support was given to 222 patients (35%) and 408 patients (65%) did not have upfront prophylaxis. Of the 222 patients who were given primary prophylaxis, 14 patients (6.3%) were diagnosed with FN. Of the 408 patients who did not receive primary prophylaxis, 120 patients (29.4%) were diagnosed with FN. All patients (n=120) diagnosed with FN received secondary prophylaxis with growth factor support. A total of 126 patients (20%) were admitted to hospital for FN. The median duration of hospital admission was 3.9 days (r: 1-65 days). The impact of risk factors, the use of filgastrim versus pegylated filgastrim on FN rates and the clinical ramifications of febrile neutropenia (ICU admissions/deaths) will be reported.Conclusions: The results of this retrospective analysis demonstrate a much higher risk of FN (29.4%) with FEC-D than has been previously reported. More complete reporting of primary prophylaxis is required. This rate of FN would warrant use of primary prophylaxis for patients prescribed FEC-D, particularly in high risk subgroups.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2087.