The Optimal Timing and Duration of Daily G-CSF for the Primary Prevention of Febrile Neutropenia in Breast Cancer Patients Undergoing Adjuvant TAC Chemotherapy

IF 1.6 4区医学 Q4 ONCOLOGY

Asia-Pacific journal of clinical oncology Pub Date : 2025-03-25 DOI:10.1111/ajco.14165

Zisun Kim, Sung Mo Hur, Jong Eun Lee, Sun Wook Han, Hae Il Jung, Sung Yong Kim, Jihyoun Lee, Cheol Wan Lim

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引用次数: 0

Abstract

Aim

TAC chemotherapy is a standard adjuvant treatment for early-stage breast cancer, with G-CSF recommended for preventing febrile neutropenia (FN). This study investigates the optimal initiation timing for daily filgrastim to prevent FN in patients undergoing TAC chemotherapy, a subject not fully explored in existing guidelines.

Methods

Sixty breast cancer patients receiving adjuvant TAC chemotherapy were randomly assigned to start daily filgrastim either on Day 2 (Day 2 group, n = 30) or Day 5 (Day 5 group, n = 30). The primary outcome was the incidence of FN. Secondary outcomes included the duration of neutropenia treatment and the neutropenia profile.

Results

Patients underwent 349 cycles of TAC chemotherapy (173 cycles in Day 2 group and 176 cycles in Day 5 group). The incidence of FN was significantly lower in the Day 2 group (6.4%, 11/173) compared to the Day 5 group (22.2%, 39/176, p < 0.0001). Additionally, the mean ± SD duration of filgrastim treatment was longer (8 ± 1 vs. 6 ± 1 days, p < 0.0001), and the duration of severe neutropenia was shorter (3 ± 1 vs. 4 ± 1 days, p = 0.001) in the Day 2 group.

Conclusion

Initiating filgrastim on Day 2 of TAC chemotherapy significantly enhances its effectiveness in preventing FN compared to starting on Day 5. These findings support early intervention and sustained treatment to optimize toxicity management in adjuvant TAC chemotherapy.

Abstract Image

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每日G-CSF用于辅助TAC化疗乳腺癌患者发热性中性粒细胞减少的最佳时间和持续时间

目的：TAC化疗是早期乳腺癌的标准辅助治疗，G-CSF被推荐用于预防发热性中性粒细胞减少症（FN）。本研究探讨了在接受TAC化疗的患者中，每日非格昔汀预防FN的最佳起始时间，这是现有指南中尚未充分探讨的主题。方法：60例接受辅助TAC化疗的乳腺癌患者，随机分配在第2天（第2天组，n = 30）或第5天（第5天组，n = 30）开始每日服用非格拉西汀。主要终点是FN的发生率。次要结局包括中性粒细胞减少治疗的持续时间和中性粒细胞减少的情况。结果：患者共接受349个周期TAC化疗（第2天组173个周期，第5天组176个周期）。与第5天相比，第2天组FN发生率显著降低（6.4%,11/173）（22.2%,39/176,p）。结论：与第5天相比，在TAC化疗第2天开始使用非格昔汀可显著提高其预防FN的有效性。这些发现支持早期干预和持续治疗以优化辅助TAC化疗的毒性管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asia-Pacific journal of clinical oncology 医学-肿瘤学

CiteScore

3.40

自引率

0.00%

发文量

175

审稿时长

6-12 weeks

期刊介绍： Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.