Reduction of chemotherapy-induced febrile leucopenia by prophylactic use of ciprofloxacin and roxithromycin in small-cell lung cancer patients: An EORTC double-blind placebo-controlled phase III study

Tjan‐Heijnen, Vivianne C. G.; Postmus, Pieter E.; Ardizzoni, Andrea; Manegold, C.; Burghouts, J.; Meerbeeck, Jan P. van; Gans, Steven; Möllers, Marius J.; Buchholz, E.; Biesma, Bonne; Legrand, Catherine; Debruyne, Channa; Giaccone, Giuseppe

doi:10.1023/a:1012545507920

Cited by 100 publications

(43 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Commonly cited risk factors for developing febrile neutropenia include poor PS, advanced-stage disease, elderly age (≥65 years), and prior chemotherapy [34,35]. A higher incidence of febrile neutropenia in the first treatment cycle than in subsequent cycles has been reported in several trials [36][37][38]. The reasons for this are unclear, but the observation indicates that preventive strategies should be implemented prior to the first cycle.…”

Section: Risk For Neutropeniamentioning

confidence: 99%

“…The reasons for this are unclear, but the observation indicates that preventive strategies should be implemented prior to the first cycle. Potential strategies for reducing the possibility of febrile neutropenia include selecting a chemotherapy regimen with a low rate of neutropenia, the use of prophylactic growth factors, and the use of prophylactic antibiotics [34,36,39]. Of the agents approved for second-line therapy, erlotinib and pemetrexed have low rates of febrile neutropenia, and these agents may be preferred if a patient is thought to be at high risk for developing febrile neutropenia or has had significant myelosuppression with first-line therapy.…”

Section: Risk For Neutropeniamentioning

confidence: 99%

See 1 more Smart Citation

Considerations for Second-Line Therapy of Non-Small Cell Lung Cancer

Stinchcombe

Socinski

2008

The Oncologist

View full text Add to dashboard Cite

For patients with advanced non-small cell lung cancer and a good functional status, platinum-based first-line chemotherapy improves quality of life, reduces diseaserelated symptoms, and improves survival. The addition of bevacizumab to carboplatin and paclitaxel in the first-line setting has been shown to produce a higher response rate and longer progression-free survival and overall survival times than with carboplatin and paclitaxel. Despite these therapies, all patients inevitably experience disease progression. There are currently three agents approved for treating patients who progress after one prior regimen: docetaxel, pemetrexed, and erlotinib. Erlotinib is also indicated for patients who progress after two prior regimens. These agents appear to have similar efficacies in terms of response and overall survival, but have significantly different toxicity profiles. Currently, the choice of agent depends on a number of factors, including the patient's comorbidities, toxicity from previous treatments, the risk for neutropenia, smoking history, and patient preference.

show abstract

Section: Risk For Neutropeniamentioning

confidence: 99%

Section: Risk For Neutropeniamentioning

confidence: 99%

Considerations for Second-Line Therapy of Non-Small Cell Lung Cancer

Stinchcombe

Socinski

2008

The Oncologist

View full text Add to dashboard Cite

show abstract

“…We have updated our meta-analysis 1 with data from recent trials 2,3 and divided the trials [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] according to the type of patient (Fig. 1).…”

Section: Which Patients Should Be Offered Antibiotic Prophylaxis?mentioning

confidence: 99%

“…In 3 of 4 studies 3,19,22 of patients with solid tumors and lymphoma, prophylaxis was started later to cover the anticipated nadir period of neutrophils. No differences in the reduction of risk for mortality or febrile episodes were evident between studies in which prophylaxis was started with the initiation of chemotherapy and studies in which prophylaxis was started with the appearance of neutropenia.…”

Section: Commencement and End Of Prophylaxismentioning

confidence: 99%

Antibiotic prophylaxis in neutropenic patients

Leibovici

Cullen

Bucaneve³

et al. 2006

Cancer

177

View full text Add to dashboard Cite

New evidence shows that antibiotic prophylaxis in neutropenic patients reduces mortality, febrile episodes, and bacterial infections. For patients with acute leukemia or those who undergo bone marrow transplantation, prophylaxis with fluoroquinolones diminished the risk of death from any cause by 33% (95% confidence interval [95% CI], 2-54%). Thus, 55 patients who have acute leukemia or who undergo bone marrow transplantation must receive prophylaxis to prevent 1 death. In 4 studies that included patients with solid tumors or lymphoma, prophylaxis reduced the rate of death during the first month (relative risk, 0.51; 95% CI, 0.27-0.97), and 82 patients had to receive prophylaxis to prevent 1 death. The main argument brought against prophylaxis is the induction of resistance. Patients who received prophylaxis did not experience more infections caused by resistant strains than patients in the control group. The recent GIMEMA study was con- N ew evidence shows that antibiotic prophylaxis in neutropenic patients reduces mortality, febrile episodes, and bacterial infections. A systematic review and meta-analysis of randomized controlled trials 1 demonstrated that death from all causes was reduced by 34% (95% confidence interval [95% CI], 21-45%) in neutropenic patients who received any antibiotic prophylaxis and by 40% (95% CI, 17-56%) in patients who received quinolones for prophylaxis. in addition, the occurrence of febrile episodes and bacterial infections decreased significantly (Table 1). Most of the studies that were included in that meta-analysis addressed patients with hematologic malignancies. In the most recent and largest randomized controlled trial that included patients in whom neutropenia was expected to occur for more than 7 days (mainly with acute leukemia and autologous peripheral blood stem cell transplantation), 2 patients who received levofloxacin as prophylaxis had a relative risk (RR) of 0.54 (95% CI, 0.25-1.16) for mortality compared with the placebo group: a Dr. Cullen has received honoraria from Sanofi Aventis.We thank Dr. Vivianne Tjan-Heijnen and Ms. Muriel Debois for supplying us with full data regarding mortality from their study.

show abstract

“…Several data suggest that the likelihood of neutropenic fever is highest during the first cycles of chemotherapy [29,30]. This may be an argument for primary prophylaxis with or without antibiotics [31].…”

Section: Growth Factors; Primary Prophylaxismentioning

confidence: 99%

Neutropenia management

Schouten¹

2006

Annals of Oncology

View full text Add to dashboard Cite

Reduction of chemotherapy-induced febrile leucopenia by prophylactic use of ciprofloxacin and roxithromycin in small-cell lung cancer patients: An EORTC double-blind placebo-controlled phase III study

Cited by 100 publications

References 22 publications

Considerations for Second-Line Therapy of Non-Small Cell Lung Cancer

Considerations for Second-Line Therapy of Non-Small Cell Lung Cancer

Antibiotic prophylaxis in neutropenic patients

Neutropenia management

Contact Info

Product

Resources

About