Prophylactic G-CSF averts febrile neutropaenia in docetaxel-treated breast cancer patients

Prophylactic granulocyte-colony stimulating factor (G-CSF) results in a significant decrease both in the rate of febrile neutropaenia (FN) and duration of hospitalization for FN in breast cancer patients treated with docetaxel-based chemotherapy regimens (DBRs), according to a recent study.

The researchers identified 276 patients treated between 2015 and 2017 from hospital pharmacy database and retrospectively examined the participants’ medical records. They also collected data from the patients’ first four cycles of DBR.

Finally, the researchers compared FN rate, FN associated length of hospital stay (FN-LOS), and chemotherapy dose modification/delay due to FN between patients who did (G-CSF group) and those who did not (non-G-CSF group) receive prophylactic G-CSF.

Of the included patients, 83.3 percent received a DBR as adjuvant or neoadjuvant therapy, and 50 percent received docetaxel as combination therapy.

Prophylactic G-CSF was administered with the first cycle of a DBR in 69.9 percent of patients; as a result, they were significantly less likely to develop FN relative to the non-G-CSF group (6.2 percent vs 15.7 percent; odds ratio [OR], 0.36, 95 percent confidence interval [CI], 0.16‒0.82; p=0.020).

The G-CSF group also had lower FN rate (4.8 vs 8.5; OR, 0.54, 95 percent CI, 0.30‒0.97; p=0.043) and mean FN-LOS (3.55 vs 5.28 days; t, ‒2.22; p=0.037) than the non-G-CSF group collectively and after the four DBR treatment cycles.

Of note, no between-group difference was observed in DBR dose delay/reduction in cycles 2‒4.

“FN is a life-threatening complication of DBRs,” the researchers said. “Prophylactic G-CSF can reduce the risk of FN.”