Risk of febrile neutropenia and early treatment cessation in men receiving standard and dose‐reduced 3‐weekly docetaxel for metastatic castration‐resistant prostate cancer

Hamid, Anis; Willson, Kaspar; Vincent, Andrew; Tamjid, Babak; Lee, Margaret; Bergin, Alice R.T.; Gan, Chun Loo; Campbell, Ainsley; Stewart, Josephine; Pezaro, Carmel; Weickhardt, Andrew

doi:10.1111/ajco.12840

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…However, in our results, similar predictors were not significant (except for ECOG PS). An Australian study of 166 mCRPC patients treated with docetaxel also found no significant association between patient baseline characteristics and FN 24 . In line with the American Society of Clinical Oncology guidelines, 25 a retrospective study of 1241 lymphoma patients receiving chemotherapy found no increased risk of FN in overweight patients 26 .…”

Section: Discussionmentioning

confidence: 91%

Prevention of docetaxel‐associated febrile neutropenia with primary granulocyte colony‐stimulating factor in Chinese metastatic hormone‐sensitive and castration‐resistant prostate cancer patients

Poon

Chan

et al. 2021

Asia-Pac J Clncl Oncology

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IntroductionAsian prostate cancer (PC) patients are particularly susceptible to docetaxel‐related febrile neutropenia (FN). We evaluated primary granulocyte colony‐stimulating factor (GCSF) for preventing FN in Chinese patients with metastatic hormone‐sensitive PC (mHSPC) and castration‐resistant PC (mCRPC).Patients and MethodsData from two cohorts of 377 Chinese patients with mHSPC (100; 26.5%) and mCRPC (277; 73.5%) treated with docetaxel at six public oncology centres were analysed with multivariate regression. Primary GCSF prophylaxis was defined as administration within 5 days of starting docetaxel. The primary outcome was FN within 21 days of the first docetaxel cycle (1st FN).ResultsPrimary GCSF was given to 71 (18.8%) patients. FN occurred in 61 patients (16.2%) including 37 (9.8%) during the first cycle. Among patients who developed 1st cycle FN (n = 37) or not (n = 340), 2 and 69 received primary GCSF (5.4 vs. 20.3%, P = .03). Primary GCSF was associated with an overall reduced risk of 1st cycle FN (odds ratio [OR] = 0.22; 95% confidence interval [CI]: 0.05‐0.96, P = .04), and similar trends were observed in the mHSPC (OR = 0.36, P = .35) and mCRPC (OR = 0.16, P = .08) subgroups. Poor Eastern Cooperative Oncology Group performance status (>1) was associated with an increased risk of 1st FN (OR = 3.90; 95% CI: 1.66‐9.13, P = .002).ConclusionsTo alleviate the risk of docetaxel‐related FN, primary GCSF prophylaxis is suggested for Asian mCRPC and mHSPC patients, particularly those with poor performance status.

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Section: Discussionmentioning

confidence: 91%

Prevention of docetaxel‐associated febrile neutropenia with primary granulocyte colony‐stimulating factor in Chinese metastatic hormone‐sensitive and castration‐resistant prostate cancer patients

Poon

Chan

et al. 2021

Asia-Pac J Clncl Oncology

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Docetaxel dose-intensity effect on overall survival in patients with metastatic castrate-sensitive prostate cancer

Kushnir

Mallick

Ong

et al. 2020

Cancer Chemother Pharmacol

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Incidence, predictors, and outcomes of febrile neutropenia and neutropenia in patients with metastatic castrate-resistant prostate cancer receiving docetaxel

Peltekian

Sajwani

Wang

et al. 2023

Support Care Cancer

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The incidence of febrile neutropenia (FN) in adults with castrate-resistant metastatic prostate cancer (mCRPC) receiving docetaxel in real-world settings since the expanded role of hormonal treatments has not been well studied. The study objective is to determine the incidence of FN and neutropenia among adults with mCRPC receiving docetaxel. Secondary objectives are to quantify outcomes of patients who develop FN and to identify predictors for FN in this population. MethodsA single-centre retrospective cohort study was conducted which included adults with mCRPC receiving docetaxel at the Ottawa Hospital over a 5-year period. Charts were reviewed to collect clinical data to determine the incidence of FN. A multiple logistic regression was used to identify predictors of FN. ResultsIn patients receiving docetaxel for mCRPC, the incidence of FN and neutropenia was 34/137 (25%) and 45/137 (33%), respectively. Among 34 patients who developed FN, 94% required hospitalization for FN for a mean of 5 days (+/-2.8) and 6% died. Following FN, 53% required at least 1 treatment delay, 71% had at least 1 dose reduction and 18% received secondary prophylaxis with WBC Growth-Factors. Age category [OR 2.025, 95% CI 1.13-3.627] and presence of multiple comorbidities [OR 1.466,] increased the risk of FN. ConclusionThe incidence of FN and neutropenia in the clinical setting in patients receiving docetaxel for mCRPC is higher than previously reported and high enough to consider primary prophylaxis in high-risk groups. Age and multiple comorbidities were identi ed as risk factors.

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Risk of febrile neutropenia and early treatment cessation in men receiving standard and dose‐reduced 3‐weekly docetaxel for metastatic castration‐resistant prostate cancer

Abstract: LD docetaxel for mCRPC did not mitigate the risk of FN or ETC due to toxicity. Dose reduction may result in poorer PSA response and survival.

Cited by 4 publications

References 26 publications

Prevention of docetaxel‐associated febrile neutropenia with primary granulocyte colony‐stimulating factor in Chinese metastatic hormone‐sensitive and castration‐resistant prostate cancer patients

Prevention of docetaxel‐associated febrile neutropenia with primary granulocyte colony‐stimulating factor in Chinese metastatic hormone‐sensitive and castration‐resistant prostate cancer patients

Docetaxel dose-intensity effect on overall survival in patients with metastatic castrate-sensitive prostate cancer

Incidence, predictors, and outcomes of febrile neutropenia and neutropenia in patients with metastatic castrate-resistant prostate cancer receiving docetaxel

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