Journal Article
. 2018 Aug; 27(3):1099-1108.
doi: 10.1007/s00520-018-4399-3.

Real-world use of granulocyte colony-stimulating factor in ambulatory breast cancer patients: a cross-sectional study

Florence Van Ryckeghem 1 Chloë Haverbeke 2 Wim Wynendaele 3 Guy Jerusalem 4 Luc Somers 5 Anke Van den Broeck 6 Sofie Vingerhoedt 6 Simon Van Belle 7 
  • PMID: 30099601
  •     33 References
  •     2 citations


Purpose: To prevent febrile neutropenia (FN), European Organisation for Research and Treatment of Cancer (EORTC) guidelines recommend primary prophylaxis with granulocyte colony-stimulating factors (PPG) for patients at high risk (≥ 20%) of FN. In Belgium, the use of PPG is restricted by specific reimbursement criteria. The impact of these criteria on PPG use and adherence to guidelines is unknown.

Methods: This multicentre, cross-sectional, observational study aimed to describe PPG use by FN risk category in breast cancer patients who were scheduled to receive myelosuppressive chemotherapy in outpatient clinics in Belgium during a 2-week period between 13 October and 12 December 2014.

Results: In total, 490 patients were enrolled. Median age was 57.0 years. Based on their chemotherapy regimen, 53.9, 5.1 and 41.0% of patients were at a low, intermediate and high risk of FN, respectively. Overall, 39.8% of patients received PPG (17.0, 12.0 and 73.1% of those receiving low-, intermediate- and high-risk regimens, respectively). In the high-risk category, PPG was used in 89.9% of dose-dense and in 25.0% of classical chemotherapy regimens. PPG use was adherent to EORTC guidelines in 75.3% of patients (30.6% appropriate use, 44.7% appropriate non-use). EORTC guidelines would recommend PPG use in 46.1% of this study population (n = 226), and its use was reimbursable in Belgium in 76.1% of these patients (n = 172), but only 66.4% of them received PPG (n = 150).

Conclusions: Both Belgian reimbursement criteria and physician decision-making led to a proportion of patients for whom PPG treatment was recommended but finally not receiving it.

Keywords: Breast cancer; Chemotherapy; Febrile neutropenia; Granulocyte colony-stimulating factor; Prophylaxis.

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