Impact of chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) on cancer treatment outcomes: An overview about well-established and recently emerging clinical data

Lalami, Yassine; Klastersky, Jean

doi:10.1016/j.critrevonc.2017.11.005

Cited by 85 publications

(102 citation statements)

References 180 publications

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“…2 Development of FN increases treatment costs and can prompt dose reductions or treatment delays, which may compromise clinical outcome. 3 Management and prevention of FN is an integral part of supportive care for many patients undergoing cancer treatment. Unfortunately, biologics such as filgrastim and pegfilgrastim are costly, which has limited their accessibility for many patients.…”

Section: Overviewmentioning

confidence: 99%

NCCN Guidelines Insights: Hematopoietic Growth Factors, Version 1.2020

Becker

Griffiths²,

Alwan

et al. 2020

Journal of the National Comprehensive Cancer Network

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Management of febrile neutropenia (FN) is an integral part of supportive care for patients undergoing cancer treatment. The NCCN Guidelines for Hematopoietic Growth Factors provide suggestions for appropriate evaluation, risk determination, prophylaxis, and management of FN. These NCCN Guidelines are intended to guide clinicians in the appropriate use of growth factors for select patients undergoing treatment of nonmyeloid malignancies. These NCCN Guidelines Insights highlight important updates to the NCCN Guidelines regarding the incorporation of newly FDA-approved granulocyte-colony stimulating factor biosimilars for the prevention and treatment of FN.

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Section: Overviewmentioning

confidence: 99%

NCCN Guidelines Insights: Hematopoietic Growth Factors, Version 1.2020

Becker

Griffiths²,

Alwan

et al. 2020

Journal of the National Comprehensive Cancer Network

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“…Cox proportional hazard regression for relapse-free survival (RFS) and overall survival (OS) Byeong Kwan Park, et al Impact of Febrile Neutropenia on Prognosis after TAC Chemotherapy 103 studies support the importance of chemotherapy dose intensity in achieving optimal clinical survival outcomes (e.g., disease free survival[DFS], and OS)[20,22,23]. In our study, RDI was significantly lower in patients who experienced FN (96.4% vs. 99.5%, p = 0.001).…”

mentioning

confidence: 99%

Incidence of Febrile Neutropenia in Advanced Breast Cancer Patients Receiving Adjuvant Docetaxel-Doxorubicin-Cyclophosphamide Chemotherapy in Korea and Its Impact on Prognosis

et al. 2019

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Purpose: The concurrent regimen of docetaxel, doxorubicin, and cyclophosphamide (TAC) has been categorized as a high-risk factor for febrile neutropenia (FN). The incidence of FN was reported to be as high as 17%-26% in studies conducted in Western countries. However, these rates may vary among different ethnic groups. This study aimed to evaluate the incidence of FN and its effect on prognosis following adjuvant TAC chemotherapy in Korean patients with advanced breast cancer. Methods: We analyzed data from 187 patients who received 6 cycles of adjuvant TAC chemotherapy between July 2005 and December 2014. No patients received long-acting granulocyte-colony stimulating factor (G-CSF) as primary prophylaxis for FN due to guidelines for cost reimbursement in Korea. The incidence rates of FN, dose reduction of TAC, relative dose intensity (RDI), relapse-free survival (RFS), and overall survival (OS) were investigated. Results: A total of 102 (54.5%) patients experienced FN, especially older patients (51 years vs. 49 years, p= 0.045). RDI was lower in patients with FN than in those without (96.4% vs. 99.5%, p= 0.001, respectively). Death was reported in 2 patients (2.35%) without FN and in 10 patients (9.80%) with FN (hazard ratio [HR]: 6.64; 95% confidence interval [CI]: 1.28 to 34.36; p= 0.024). No significant differences in RFS (p= 0.235) were found using Kaplan-Meier analysis. Conclusion: The incidence of FN was significantly higher in Korea than in Western countries, and FN had a negative impact on the patients' prognosis. Primary prophylactic G-CSF should be prioritized in Korean patients with advanced breast cancer who receive adjuvant TAC chemotherapy.

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“…However, this could be confounded by the limited sample size for subgroup analysis. Notably, the ANC at the onset of taxane-induced colitis was recorded to help distinguish chemotherapy-induced colitis from neutropenic colitis, as cancer patients who receive chemotherapy are at high risk of neutropenia [30]. We observed a normal range of ANCs at the time of colitis presentation.…”

Section: Discussionmentioning

confidence: 65%

Clinical characteristics of colitis induced by taxane-based chemotherapy

Chen

Abu-Sbeih

Thirumurthi

et al. 2019

aog

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Background Limited data are available concerning the clinical features of toxic gastrointestinal (GI) effects of taxane-based therapy. We describe the clinical, endoscopic and histologic features of taxane-induced colitis. Methods This retrospective study included cancer patients who received taxane therapy and underwent colonoscopy for GI symptoms from 2000-2018. Results Of the 45,527 patients who received taxane therapy during the study period, 76 (0.2%) met the inclusion criteria. Most patients (54%) received paclitaxel, 37% docetaxel, and 9% nab-paclitaxel. The median time from taxane therapy initiation to colitis symptom onset was 31 days. The median duration of colitis symptoms was 30 days. Colitis treatment comprised immunosuppressive therapy in 8 patients (11%), antibiotics in 17 (22%), antimotility agents in 18 (24%), and octreotide or somatostatin in 2 (3%). Thirty-five patients (46%) required hospitalization and seven (9%) required admission to the intensive care unit (ICU). Endoscopy revealed mucosal ulceration in 19 patients (25%), nonulcerative inflammation in 32 (42%), and normal findings in 25 (33%). Seventeen patients (22%) had features of lymphocytic colitis. One patient had spontaneous colonic perforation that required surgical intervention. Colitis symptoms recurred in 7 patients (9%) after initial improvement. Patients who received nab-paclitaxel developed GI toxicity earlier (P=0.003), required colitis-related hospitalization more frequently (P=0.005), and received intravenous fluids more frequently (P=0.025), compared with patients who received other taxanes. Conclusions Taxane-related colitis can present with significant inflammation on colonoscopy, and in a minority of patients as microscopic colitis. Taxane-induced colitis, although uncommon, can lead to ICU admission and colonic perforation.

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Impact of chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) on cancer treatment outcomes: An overview about well-established and recently emerging clinical data

Cited by 85 publications

References 180 publications

NCCN Guidelines Insights: Hematopoietic Growth Factors, Version 1.2020

NCCN Guidelines Insights: Hematopoietic Growth Factors, Version 1.2020

Incidence of Febrile Neutropenia in Advanced Breast Cancer Patients Receiving Adjuvant Docetaxel-Doxorubicin-Cyclophosphamide Chemotherapy in Korea and Its Impact on Prognosis

Clinical characteristics of colitis induced by taxane-based chemotherapy

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