Neutropenic complications in the PANTHER phase III study of adjuvant tailored dose-dense chemotherapy in early breast cancer

• Published in: Acta oncologica 2020-01, Vol.59 (1), p.75-81
• Main Authors: Papakonstantinou, Antroula, Hedayati, Elham, Hellström, Mats, Johansson, Hemming, Gnant, Michael, Steger, Günther, Greil, Richard, Untch, Michael, Moebus, Volker, Loibl, Sibylle, Foukakis, Theodoros, Bergh, Jonas, Matikas, Alexios
• Format: Article
• Language: English
• ISSN: 0284-186X; 1651-226X
• DOI: 10.1080/0284186X.2019.1670353

Introduction: Myelosuppresion is a common side effect of chemotherapy and granulocyte-colony stimulating factor (G-CSF) is often used to reduce the risk of neutropenic events. The purpose of this exploratory analysis was to investigate neutropenic complications in the phase III PANTHER trial of standard 3-weekly chemotherapy with 5-fluorouracil, epirubicin and cyclophosphamide plus docetaxel (FEC/D) versus bi-weekly tailored dose-dense EC/D adjuvant chemotherapy in breast cancer. Patients and methods: Febrile neutropenia, neutropenic infection and infection grade 3-4 according to CTC AE 3.0, were explored in relation to G-CSF use. Per cycle analysis was performed concerning dose reduction and dose delays in conjunction with G-CSF administration. Results: In the experimental group, 98.9% of patients received primary G-CSF support during EC and 97.4% during docetaxel, compared with 49.7% during FEC and 63.88% during docetaxel in the standard group. Overall, the use of G-CSF was associated with a lower risk for developing neutropenic events (OR 0.44, 95% CI 0.35-0.55, p