Purpose: The objective of this study was to compare low-dose filgrastim (150 microg/day subcutaneously) with standard-dose subcutaneous filgrastim (300 microg/day) or lenograstim (263 microg/day) in preventing febrile neutropenia and hospitalizations in breast cancer patients receiving the docetaxel-doxorubicin-cyclophosphamide regimen.
Methods: A single-center retrospective data analysis was performed involving 22 adult women with breast cancer who concurrently received the docetaxel-doxorubicin-cyclophosphamide chemotherapy regimen and low-dose filgrastim from March 2004 to February 2007. Data from this study were compared to previously published data in which patients received standard-dose filgrastim or lenograstim.
Results: More patients developed febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (32% versus 7.5%, respectively; p = 0.0014; relative risk [RR] = 4.24; 95% confidence interval [CI], 2.04-7.83). More patients were hospitalized due to febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (32% versus 6.5%, respectively; p < 0.001; RR = 4.89; 95% CI, 2.32-9.13). More chemotherapy cycles resulted in febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (6.7% versus 1.2%, respectively; p < 0.001; RR = 5.58; 95% CI, 2.49-12.27).
Conclusion: In patients with breast cancer treated with the docetaxel-doxorubicin-cyclophosphamide regimen, low-dose filgrastim was associated with a higher frequency of febrile neutropenia, hospitalization due to febrile neutropenia, and cycles with febrile neutropenia compared with a historical control group treated with standard-dose filgrastim or lenograstim.
Prophylaxis of chemotherapy-induced febrile neutropenia with granulocyte colony-stimulating factors: where are we now?
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