High Rate of Febrile Neutropenia in Patients With Operable Breast Cancer Receiving Docetaxel and Cyclophosphamide

Real-World Experience with Adjuvant FEC-D Chemotherapy in Four Ontario Regional Cancer Centres

“…Others have recently reported that toxicity rates with another emerging regimen (docetaxel-cyclophosphamide) are significantly higher in routine clinical practice than were reported in the pivotal publication 17 . What accounts for such observations is not evident, but a number of plausible explanations can be considered, including fundamental differences in the patient population, treatment delivery, supportive care, and other unmeasured factors.…”

“…However, it is possible that unaccounted-for supportive measures were received by patients enrolled on pacs-01. Others have postulated a similar explanation for such observations 17 , and a recent paper 12 demonstrated that, of clinical trial reports, a significant proportion lack essential therapeutic details necessary for appropriate adoption of the reported therapy in the real world. Specifically, the authors found that premedication, growth factor support, and dose adjustments for toxicities-all of which are likely to have significant impact on adverse events experienced by patients-were the least-reported details.…”

“…The generalizability of large randomized controlled trials and their translation into effective and safe care of patients in the general population has been of interest recently [12][13][14][15][16][17] . We undertook a multi-institutional review of patients with early-stage invasive breast cancer treated with adjuvant fec-d chemotherapy at 4 tertiary cancer centres in Ontario, examining supportive care practices and toxicity during the course of adjuvant chemotherapy.…”

Real-World Impact of Granulocyte-Colony Stimulating Factor on Febrile Neutropenia

“…Interestingly, the reported incidence of fn associated with specific chemotherapy regimens is higher in clinical practice than in clinical trials 19,21,[23][24][25] . Likewise, although international guidelines are clear on the use of g-csf prophylaxis, data on such use in clinical practice remain scarce.…”

“…Although the risk of fn for several chemotherapy regimens has been widely described within the context of clinical trials, only a few studies have described the occurrence of fn in clinical practice [19][20][21][22][23] . Interestingly, the reported incidence of fn associated with specific chemotherapy regimens is higher in clinical practice than in clinical trials 19,21,[23][24][25] .…”