Reduced pegfilgrastim dose lowers neutropaenia-related events in breast cancer patients

A reduction in pegfilgrastim doses among patients on myelosuppressive chemotherapy for breast cancer leads to a low incidence of neutropaenia-related events, including febrile and grade 3/4 neutropaenia, suggests a study.

“Pegfilgrastim can be utilized to prevent neutropaenia-associated complications in patients receiving myelosuppressive chemotherapy for breast cancer,” the investigators said. “A common adverse event associated with pegfilgrastim is bone pain.”

To examine the impact of administering reduced doses of pegfilgrastim on neutropaenia-associated outcomes in patients with breast cancer receiving myelosuppressive chemotherapy, a retrospective chart review was carried out at a large, multistate health system with different medical oncology practice sites.

The incidence of febrile neutropaenia was the primary outcome, while secondary ones included the incidence and severity of neutropaenia, hospitalization for febrile, use of intravenous antimicrobials for febrile, delays in chemotherapy or dose reductions in chemotherapy secondary to neutropaenia or febrile, rationale for dose reduction of pegfilgrastim, and improvement in bone pain.

Eighty patients received a reduced dose of pegfilgrastim. Most of them had their doses reduced secondary to bone pain (54 percent) or leukocytosis (14 percent).

One (1.25 percent) patient had febrile neutropaenia that did not require hospitalization or intravenous antimicrobials. One (1.25 percent) patient experienced chemotherapy treatment delays and two had dose reduction secondary to neutropaenia or febrile neutropenia.

“Clinicians may opt to reduce the dose of pegfilgrastim when administering it to patients with previous severe or refractory bone pain,” the investigators said.