Abstract
The febrile neutropenia (FN) rates reported with the docetaxel 75 mg/m2 plus cyclophosphamide 600 mg/m2 (TC) regimen given every 3 weeks vary from 4 to 69 % in early-stage breast cancer (ESBC) patients. This creates uncertainty as to whether patients receiving the TC regimen should also receive granulocyte colony-stimulating factor primary prophylaxis (G-CSFpp), which is recommended when chemotherapy regimens have ≥20 % FN rate. We conducted a meta-analysis of published studies to determine FN rate with the TC regimen, its dependence on patients’ age, and the efficacy of G-CSFpp in reducing it in ESBC patients. We systematically searched the literature via PUBMED using the following terms: ‘docetaxel’, ‘cyclophosphamide’, ‘febrile neutropenia’, and ‘breast cancer’. Inclusion criteria were full text peer-reviewed clinical studies in English reporting FN rates with TC regimen in relationship to G-CSFpp. Comprehensive meta-analysis software was used for all statistical analyses. Eight studies (N = 1542 patients) were included in our meta-analysis. The pooled mean FN rate was 23.2 % (95 % confidence interval (CI) 6.9–55.2 %; Q = 218.17, I2 = 97.7). The FN risk in <65 years old patients was lower by 67.7 % compared to that in patients ≥65 years old (pooled odds ratio (OR) 0.323; 95 % CI 0.127–0.820; P = 0.017). The FN risk was reduced by 92.3 % with G-CSFpp (pooled OR 0.077; 95 % CI 0.013–0.460; P = 0.005). Our meta-analysis demonstrated that TC regimen was associated with ≥20 % FN risk, which was significantly higher in patients ≥65 years old and improved with G-CSFpp. G-CSFpp should be considered for all ESBC patients receiving TC regimen, especially those ≥65 years old.
Original language | English (US) |
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Pages (from-to) | 591-597 |
Number of pages | 7 |
Journal | Breast Cancer Research and Treatment |
Volume | 153 |
Issue number | 3 |
DOIs | |
State | Published - Oct 3 2015 |
Keywords
- Breast cancer
- Cyclophosphamide
- Docetaxel
- Febrile neutropenia
- G-CSF
- Primary prophylaxis
ASJC Scopus subject areas
- Oncology
- Cancer Research