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Chemotherapy treatment patterns and neutropenia management in gastric cancer

Gastric Cancer, 5 May 2014 [Peer Reviewed Journal]

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  • Title:
    Chemotherapy treatment patterns and neutropenia management in gastric cancer
  • Author: Kalinka-Warzocha, Ewa ; Plazas, Javier Gallego ; Mineur, Laurent ; Salek, Tomas ; Hendlisz, Alain ; DeCosta, Lucy ; Vogl, Florian D. ; Passalacqua, Rodolfo
  • Found In: Gastric Cancer, 5 May 2014 [Peer Reviewed Journal]
  • Subjects: Febrile Neutropenia ; Gastric Cancer ; Granulocyte Colony Stimulating Factor ; Myelosuppressive Chemotherapy ; Observational Research ; Primary Prophylaxis
  • Rights: Copyright 2014 Elsevier B.V., All rights reserved.
  • Description: Byline: Ewa Kalinka-Warzocha (1), Javier Gallego Plazas (2), Laurent Mineur (3), Tomas Salek (4), Alain Hendlisz (5), Lucy DeCosta (6), Florian D. Vogl (7), Rodolfo Passalacqua (8) Keywords: Febrile neutropenia; Gastric cancer; Granulocyte colony stimulating factor; Myelosuppressive chemotherapy; Primary prophylaxis; Observational research Abstract: Background Potentially myelosuppressive doublet and triplet chemotherapy combination regimens are considered the most active treatments in gastric cancer. This multicenter prospective observational study was designed to gain insight into the chemotherapy regimens being used in Europe and to evaluate neutropenia management in patients identified as at high risk for febrile neutropenia (FN). Methods Eligible patients had gastric cancer, were scheduled for a[yen] 3 cycles of myelosuppressive chemotherapy, and had an investigator-assessed overall FN risk a[yen] 20 %. Data were collected for up to ten cycles. The primary endpoint was the proportion of patients who received granulocyte colony stimulating factor (G-CSF) primary prophylaxis (defined as G-CSF initiated on days 1--7 of cycle 1). Secondary endpoints included FN incidence, chemotherapy administration, and G-CSF use. Results Of 199 patients who met the eligibility criteria and started at least one cycle of chemotherapy, mean age was 63 years, 76 % were men, 83 % had an ECOG score of 0 or 1, 54 % had metastatic disease, and 24 % had received prior chemotherapy. A total of 27 different backbone regimens were given the most common regimen was modified docetaxel, cisplatin, and 5-fluorouracil (DCF). Despite all patients having been identified as having a a[yen] 20 % FN risk, only 70 (35 %) received G-CSF primary prophylaxis. FN occurred in 14 patients overall (7 %). Most FN events occurred in patients who received DCF/modified DCF (9/14 events, 64 %). Conclusions The results of this study reveal a high use of myelotoxic treatment regimens in gastric cancer in Europe and low adherence to clinical practice guidelines for the use of primary and secondary G-CSF prophylaxis for FN. Author Affiliation: (1) Wojewodzki Szpital, Pabianicka 62, 93-513, Lodz, Poland (2) Hospital General Universitario de Elche, Elche, Spain (3) Clinique Sainte Catherine, Sainte Catherine Institut, Avignon, France (4) Narodny Onkologicky Ustav, Bratislava, Slovakia (5) Institut Jules Bordet, Brussels, Belgium (6) Amgen, Uxbridge, UK (7) Amgen Europe GmbH, Zug, Switzerland (8) Istituti Ospitalieri di Cremona, Cremona, Italy Article History: Registration Date: 11/04/2014 Received Date: 04/12/2013 Accepted Date: 28/03/2014 Online Date: 05/05/2014
  • Identifier: ISSN: 14363291 ; E-ISSN: 14363305 ; DOI: 10.1007/s10120-014-0375-x

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