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The incidence and risk factors of febrile neutropenia in chemotherapy-naïve lung cancer patients receiving etoposide plus platinum

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Abstract

Purpose

This study was to determine the incidence and risk factors of febrile neutropenia in chemotherapy-naïve Japanese patients treated systemically with etoposide plus platinum for lung cancer.

Methods

The study was a retrospective analysis of 244 patients who were monitored for febrile neutropenia through multiple cycles of the combination of etoposide with platinum, and the associations between incidence of febrile neutropenia and patient characteristics were evaluated.

Results

Eighty-eight patients were treated with etoposide plus cisplatin and 156 were treated with etoposide plus carboplatin. Of the 244 patients treated, 198 (81.1%) completed 4 cycles for chemotherapy. Febrile neutropenia was observed in 48 of 244 patients (19.7%), including 18 of 88 (20.5%) patients who received etoposide plus cisplatin and 30 of 156 (19.2%) patients who received etoposide plus carboplatin. Grade 3 or 4 of neutropenia was experienced by a total of 208 patients (85.2%); 79 of 88 (89.8%) receiving etoposide plus cisplatin and 129 of 156 (82.7%) receiving etoposide plus carboplatin. Male gender and previous radiotherapy were identified by multivariate analysis as independent risk factors for febrile neutropenia.

Conclusions

These results contrast with findings in Western patients and suggest that ethnic differences exist in the incidence of febrile neutropenia in patients receiving etoposide plus platinum chemotherapy. In addition, our results suggest that primary prophylaxis with granulocyte colony-stimulating factor should be considered for patients with these risk factors for febrile neutropenia prior to treatment with etoposide plus platinum.

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Abbreviations

ANC:

Absolute neutrophil count

CE:

Etoposide plus carboplatin

ECOG PS:

Eastern Cooperative Oncology Group performance status

ED:

Extensive disease

G-CSF:

Granulocyte colony-stimulating factor

JCOG:

Japan Clinical Oncology Group

PE:

Etoposide plus cisplatin

SCLC:

Small-cell lung cancer

SPE:

Split doses of cisplatin plus etoposide

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Author information

Authors and Affiliations

  1. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka, 411-8777, Japan

    Takumi Fujiwara, Hirotsugu Kenmotsu, Tateaki Naito, Takahisa Kawamura, Nobuaki Mamesaya, Mie Kotake, Haruki Kobayashi, Shota Omori, Kazuhisa Nakashima, Kazushige Wakuda, Akira Ono, Haruyasu Murakami & Toshiaki Takahashi

  2. Clinical Research Center, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka, 411-8777, Japan

    Katsuhiro Omae & Keita Mori

  3. Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka, 411-8777, Japan

    Masahiro Endo

  4. Division of Respiratory Medicine, Minami Kyusyu National Hospital, 1882 Kida, Kajiki-cho, Aira-shi, Kagoshima, 899-5241, Japan

    Tetsuhiko Taira

Authors
  1. Takumi Fujiwara
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  2. Hirotsugu Kenmotsu
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  12. Tetsuhiko Taira
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  15. Keita Mori
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Corresponding author

Correspondence to Hirotsugu Kenmotsu.

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Funding

This study was supported by Japan Agency for Medical Research and Development (15ck0106131h0002).

Conflict of interest

Takumi Fujiwara has received honoraria from Kyowa Hakko Kirin. Hirotsugu Kenmotsu has received research funding from AstraZeneca/MedImmune, Boehringer Ingelheim, Chugai Pharma and honoraria from AstraZeneca, Boehringer Ingelheim, Ono Pharmaceutical, Eli Lilly Japan, Chugai Parma, Taiho Pharmaceutical, Bristol-Myers Squibb, and Kyowa Hakko Kirin. Tateaki Naito has received honoraria from Ono Pharmaceutical. Takahisa Kawamura has received honoraria from AstraZeneca. Haruki Kobayashi has received honoraria from Taiho Pharmaceutical and Eli Lilly Japan. Shota Omori has received honoraria from Ono Pharmaceutical. Kazuhisa Nakashima has received honoraria from Ono Pharmaceutical, Taiho Pharmaceutical and Eli Lilly Japan. Kazushige Wakuda has received honoraria from Ono Pharmaceutical, Taiho Pharmaceutical, AstraZeneca, Boehringer Ingelheim, Chugai Pharma and Eli Lilly Japan. Akira Ono has received honoraria from Chugai Pharma, Taiho Pharmaceutical and research funding to our institution from Takeda Pharmaceuticals and Taiho Pharmaceutical. Haruyasu Murakami has received honoraria from Nippon Boehringer Ingelheim, Pfizer, Chugai Pharma, Taiho Pharmaceutical, AstraZeneca, Eli Lilly Japan, Ono Pharmaceutical, Bristol-Myers Squibb Japan, Novartis, and Astellas Pharma. Keita Mori has received honoraria from Ono Pharmaceutical and AstraZeneca and research funding from Boehringer Ingelheim. Masahiro Endo has received honoraria from Ono Pharmaceutical, AstraZeneca, Taiho Pharmaceutical, Daiichi sankyo and Bayer Pharmaceutical. Toshiaki Takahashi has received honoraria from Eli Lilly Japan, AstraZeneca, Chugai Pharma, Boehringer Ingelheim, Pfizer Japan, Ono Pharmaceutical and Taiho Pharmaceutical and research funding from Takeda Pharmaceuticals and MSD. For the remaining authors no conflict interested are declared.

Disclosure of commercial interest

None of the authors has any commercial interests associated with this study or received any financial or material support for this study.

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For this type of study formal consent is not required.

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Fujiwara, T., Kenmotsu, H., Naito, T. et al. The incidence and risk factors of febrile neutropenia in chemotherapy-naïve lung cancer patients receiving etoposide plus platinum. Cancer Chemother Pharmacol 79, 1229–1237 (2017). https://doi.org/10.1007/s00280-017-3324-7

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