Association between Breast Cancer Polygenic Risk Score and Chemotherapy-Induced Febrile Neutropenia: Null Results

Ong, Simon Yew Kuang; Ho, Peh Joo; Khng, Alexis Jiaying; Lim, Elaine; Wong, Fuh Yong; Tan, Benita Kiat‐Tee; Lim, Swee Ho; Tan, Ern Yu; Tan, Su-Ming; Tan, Veronique Kiak Mien; Dent, Rebecca; Tan, Tira Jing Ying; Ngeow, Joanne; Madhukumar, Preetha; Hamzah, Julie Liana Bte; Sim, Yirong; Lim, Geok Hoon; Pang, Jinnie; Alcantara, Veronica Siton; Chan, Peter; Chen, Juliana Jia Chuan; Kuah, Sherwin; Seah, Jaime Chin Mui; Tang, Siau Wei; Ng, Celene Wei Qi; Li, Jingmei; Hartman, Mikael

doi:10.3390/cancers14112714

Cited by 4 publications

(5 citation statements)

References 42 publications

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Section: Discussionmentioning

confidence: 99%

“…It should be highlighted that the majority of published ndings on cancer pharmaco-ethnicity are restricted to three ethnic groups: Asians, Caucasians, and African Americans(13). Hence, there is a need to further explore the prevalence and risk factors of FN in other ethnic groups or geographic settings (7,11,14).In this two-part study, we rst examined the incidence of chemotherapy-induced FN in a retrospective cohort study comprising 1,014 breast cancer patients in Singapore. Using the independent Joint Breast Cancer Registry, we further studied the incidence of FN amongst 7,449 chemotherapy-treated patients as well as associations between ethnicity and other patient, tumour, and treatment characteristics.…”

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confidence: 99%

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Ethnic disparity in chemotherapy–induced febrile neutropenia incidence in Asian breast cancer patients: A retrospective cohort study

Lim

Hartman

et al. 2023

Preprint

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Background Majority of published findings on chemotherapy–induced febrile neutropenia (FN) are restricted to three ethnic groups: Asians, Caucasians, and African Americans. In this two–part study, we examined FN incidence and risk factors in Chinese, Malay and Indian chemotherapy–treated breast cancer (BC) patients in Southeast Asia. Methods Hospital records or ICD codes (fever:ICD9/10:2880/D70 and neutropenia:ICD9/10:7806/R509) were used to identify patients with FN, during or within 30 days from the last chemotherapy session. In both Singapore Breast Cancer Cohort (SGBCC) and Joint Breast Cancer Registry (JBCR), time to first FN from start of chemotherapy was estimated using Cox regression. Multinomial regression was used to evaluate differences in patient, tumour, and treatment characteristics across ethnicities. Results FN was observed in 170 of 1,014 patients (16.7%) in SGBCC. Cox model showed that non–Chinese were at higher risk of developing FN (HRMalay[95% CI]:2.04[1.44–2.88], p < 0.001; HRIndian:1.88[1.11–3.18], p = 0.018). In JBCR, FN was observed in 965 of 7449 patients (13.0%). Indian patients, lower baseline absolute neutrophil count, non– luminal A proxy subtypes, and anthracycline–containing regimens were identified as risk factors for FN in the univariable Cox models. Disparities across ethnicities risk (HRMalay: 1.29 [1.07–1.54], p = 0.006; HRIndian: 1.50 [1.19–1.88], p < 0.001) remained significant even after further adjustments. Finally, age–adjusted multinomial model showed that as compared to Chinese patients, non–Chinese (ORMalay vs Chinese(ref):3.65[1.45–9.16],p = 0.006;ORIndian vs Chinese(ref):4.43[1.45–13.60],p = 0.009) were significantly more likely to develop multiple episodes of FN during treatment. Conclusion Ethnic differences in chemotherapy–induced FN among BC patients exist. Further studies can focus on investigating pharmacogenetic differences across ethnicities.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Ethnic disparity in chemotherapy–induced febrile neutropenia incidence in Asian breast cancer patients: A retrospective cohort study

Lim

Hartman

et al. 2023

Preprint

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“…When neutropenia is accompanied by fever, it leads to FN, a potentially life-threatening condition that requires immediate medical attention and intervention. The incidence of chemotherapy-induced neutropenia and FN among breast cancer patients is up to 31.9% and 5.3%, respectively [6,7], and they are associated with a risk of life-threatening infections [8]. These complications often lead to treatment delays and dose reductions, negatively impacting treatment e cacy and compromising patient morbidity and survival [7].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of chemotherapy-induced neutropenia and FN among breast cancer patients is up to 31.9% and 5.3%, respectively [6,7], and they are associated with a risk of life-threatening infections [8]. These complications often lead to treatment delays and dose reductions, negatively impacting treatment e cacy and compromising patient morbidity and survival [7]. To prevent chemotherapy-induced neutropenia/FN, primary prophylaxis with granulocyte colonystimulating factor (G-CSF) and prophylactic antibiotics are recommended in high-risk patients [8,9].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitude, and practice toward chemotherapy-related neutropenia and febrile neutropenia among breast cancer patients Running title: KAP of chemotherapy neutropenia in breast cancer

Chen,

Zhou,

Jiang

2023

Preprint

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Aims This study aimed to investigate the knowledge, attitude, and practice (KAP) toward chemotherapy-related neutropenia and febrile neutropenia (FN) among breast cancer patients. Materials and methods A multi-center cross-sectional study enrolled breast cancer chemotherapy patients at four hospitals between April and June 2023. A self-administered questionnaire was developed to assess KAP scores. The structural equation model (SEM) was used to analyze the interactions between patients' knowledge and attitude and demographic characteristics. Results A total of 246 patients completed the questionnaire. The mean knowledge score was 12.46 ± 6.21 (possible range: 0–26) and the mean attitude score was 30.00 ± 2.58 (possible range: 7–35). Less than half of the patients knew whether their chemotherapy protocol was a high-risk protocol for FN (45.95%). However, the majority of patients were aware of the need for the prophylactic administration of leukocyte-raising agents (79.67%). Multivariate logistic regression analysis showed that junior college and above (OR = 4.69, 95% CI = 2.23–9.89, P < 0.001) was associated with adequate knowledge. Living in urban areas (OR = 0.58, 95% CI = 0.34–0.97, P = 0.037) was associated with positive attitude. The SEM showed that experience with chemotherapy-related neutropenia or FN had a direct effect on knowledge (β = 1.77, p = 0.029). Conclusion This study found inadequate knowledge, positive attitude and suboptimal practice toward chemotherapy-related neutropenia and FN among breast cancer chemotherapy patients. Tailored and effective education programs need to be designed and implemented to improve relevant KAP in this patient population.

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“…It should be highlighted that the majority of published findings on cancer pharmaco-ethnicity are restricted to three ethnic groups: Asians, Caucasians, and African Americans [13]. Hence, there is a need to further explore the prevalence and risk factors of FN in other ethnic groups or geographic settings [7,11,14].…”

Section: Introductionmentioning

confidence: 99%

How Asian Breast Cancer Patients Experience Unequal Incidence of Chemotherapy Side Effects: A Look at Ethnic Disparities in Febrile Neutropenia Rates

Lim

Hartman

et al. 2023

Cancers

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The majority of published findings on chemotherapy-induced febrile neutropenia (FN) are restricted to three ethnic groups: Asians, Caucasians, and African Americans. In this two-part study, we examined FN incidence and risk factors in Chinese, Malay, and Indian chemotherapy-treated breast cancer (BC) patients. Hospital records or ICD codes were used to identify patients with FN. In both the Singapore Breast Cancer Cohort (SGBCC) and the Joint Breast Cancer Registry (JBCR), the time of the first FN from the start of chemotherapy was estimated using Cox regression. Multinomial regression was used to evaluate differences in various characteristics across ethnicities. FN was observed in 170 of 1014 patients in SGBCC. The Cox model showed that non-Chinese were at higher risk of developing FN (HRMalay [95% CI]:2.04 [1.44–2.88], p < 0.001; HRIndian:1.88 [1.11–3.18], p = 0.018). In JBCR, FN was observed in 965 of 7449 patients. Univariable Cox models identified ethnicity, a lower baseline absolute neutrophil count, non-luminal A proxy subtypes, and anthracycline-containing regimens as risk factors. Disparities across ethnicities’ risk (HRMalay:1.29 [1.07–1.54], p = 0.006; HRIndian:1.50 [1.19–1.88], p < 0.001) remained significant even after further adjustments. Finally, an age-adjusted multinomial model showed that Malays (p = 0.006) and Indians (p = 0.009) were significantly more likely to develop multiple episodes of FN during treatment. Ethnic differences in chemotherapy-induced FN among BC patients exist. Further studies can focus on investigating pharmacogenetic differences across ethnicities.

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Association between Breast Cancer Polygenic Risk Score and Chemotherapy-Induced Febrile Neutropenia: Null Results

Cited by 4 publications

References 42 publications

Ethnic disparity in chemotherapy–induced febrile neutropenia incidence in Asian breast cancer patients: A retrospective cohort study

Ethnic disparity in chemotherapy–induced febrile neutropenia incidence in Asian breast cancer patients: A retrospective cohort study

Knowledge, attitude, and practice toward chemotherapy-related neutropenia and febrile neutropenia among breast cancer patients Running title: KAP of chemotherapy neutropenia in breast cancer

How Asian Breast Cancer Patients Experience Unequal Incidence of Chemotherapy Side Effects: A Look at Ethnic Disparities in Febrile Neutropenia Rates

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