Background/Aim: This study aimed was to clarify the impact of pegfilgrastim (PEG) 3.6 mg primary prophylaxis of febrile neutropenia (FN) on the average relative dose intensity (ARDI) of neoadjuvant/adjuvant FEC-100 for breast cancer. Materials and Methods: This retrospective, single-centre cohort study including 296 patients who received FEC-100 compared PEG and non-PEG groups. The PEG group received PEG 3.6 mg as a single subcutaneous injection in each study cycle. The primary endpoint was the ARDI of FEC-100. The secondary endpoints were patient percentage of ARDI≥85%, factors associated with ARDI≥85%, and reasons for reduced ARDI. Results: The PEG group showed significantly higher mean ARDI (95.6% versus 90.7%, p<0.001) and patient percentage of ARDI≥85% (93.0% versus 79.9%, p=0.001). PEG was significantly associated with ARDI≥85% (p=0.009). Neutropenia and FN, the main reasons for reduced ARDI, were significantly lower in the PEG group (p<0.05). Conclusion: Primary PEG 3.6 mg prophylaxis increased the ARDI of FEC-100.FEC-100 chemotherapy (fluorouracil, epirubicin, and cyclophosphamide) has been established as a standard neoadjuvant or adjuvant therapy for breast cancer (1-3) and is widely used in clinical practice (4, 5). In the phase II clinical study for FEC-100 chemotherapy in Japan, grade ≥3 neutropenia and febrile neutropenia (FN) occurred in 44% and 20% of patients, respectively, and dose reduction due to their toxicities was required in about 15% (6). Dose reduction and treatment delay due to toxicities affect relative dose intensity (RDI).In a comprehensive systematic review and meta-analysis of 17 randomised, controlled trials (RCTs), neutropenic events had a significant impact on RDI for patients receiving adjuvant anthracycline-based chemotherapy for early breast cancer. According to the results of this study, the decrease rate of RDI due to neutropenia was a mean of 8.9% and a median of 8.2%. Furthermore, of the patients with neutropenic events, 32% did not achieve an RDI of 85%, compared to 7% of patients in the group with no events (7). Bonadonna et al. (8) and Chirivella et al. (9) reported that patients who received an RDI≥85% have a significantly higher probability of survival. The French Adjuvant Study Group 05 Randomized Trial showed benefit in terms of disease-free survival and overall survival when the epirubicin dose was increased from 50 mg/m 2 to 100 mg/m 2 in FEC chemotherapy (10). Given the above results, maintaining RDI as high as possible might contribute greatly to survival.Updated guidelines from the American Society of Clinical Oncologists (ASCO) (11), the National Comprehensive Cancer Network (NCCN) (12), the European Organization for the Research and Treatment of Cancer (EORTC) (13), and the Japanese Society of Medical Oncology (JSMO) (14) recommend routine use of granulocyte colony-stimulating factors (G-CSF) for chemotherapy regimens with an FN risk ≥20%. For regimens with an FN risk of 10-20%, individual patient risk factors such as age and disease stage should be taken i...

Modified IFL therapy is an effective and well-tolerated regimen for Japanese patients with metastatic colorectal cancer. Modified IFL therapy combined with biological agents might remain an option for some patients who refuse a central venous catheter.

The control of delayed emesis is very important in order to continue ambulatory chemotherapy. We performed retrospective study that examined the e‹cacy of preventive treatment (granisetron＋dexamethasone＋domperidone) for delayed emesis induced by FOLFOX4 chemotherapy for advanced and recurrent colorectal cancer. The subjects were 92 patients who underwent FOLFOX4 chemotherapy at the Cancer Institute Hospital of JFCR (group with preventive treatment: 50, group without preventive treatment: 42), and the observation period was set as the 1st 9th cycle. The complete nausea inhibition rate was 50.0％ in the group with and 21.5％ in the group without preventive treatment, showing a signiˆcantly higher inhibition rate in the former ( p＝0.0047). The complete vomiting inhibition rates were 86.0％ and 66.7％, respectively, again showing a signiˆcantly higher inhibition rate in the former ( p＝0.015). On multivariate analysis (multiple logistic analysis), the development of nausea/vomiting and preventive treatment for delayed emesis were signiˆcantly associated, showing that the treatment was an independent preventive factor. All adverse reactions induced by preventive treatment were mild, suggesting no safety-related problem. Theseˆndings suggested the usefulness of preventive treatment with granisetron, dexamethasone, and domperidone for FOLFOX4 chemotherapyinduced delayed emesis.

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On page 844, beginning on line 1 in the right column, ''The median PFS of the 47 patients was 6.1 months (95% CI, 6.0-9.9 months)'' should be ''The median PFS of the 47 patients was 8.6 months.'' On page 844, beginning on line 8 in the right column, ''The median OS of the 47 patients was 17.4 months (95% CI, 15.9-22.9 months)'' should be ''The median OS of the 47 patients was 27.8 months.''