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International Journal of Clinical Pharmacy

, Volume 40, Issue 5, pp 997–1000 | Cite as

Optimal timing for pegfilgrastim administration in Japanese breast cancer patients receiving intermediate-risk chemotherapies

  • Tatsuya Hayama
  • Kenichi Sakurai
  • Katsuhiro MiuraEmail author
  • Shinsaku Washinosu
  • Shinya Tsuboi
  • Akihiro Uchiike
  • Yoshikazu Yoshida
  • Masami Takei
Short Research Report

Abstract

Background Pegfilgrastim is widely used for prophylaxis of febrile neutropenia (FN) in cancer patients receiving chemotherapies. However, the optimal timing of pegfilgrastim administration has not been established. Objective We investigated the effect of the timing of pegfilgrastim administration on the prevention of FN in patients with breast cancer undergoing intermediate-risk chemotherapies. Method We retrospectively analysed the incidence of FN in patients with breast cancer treated at our institution with intermediate-risk chemotherapies and primary or secondary prophylactic pegfilgrastim between 2015 and 2017. The impact of the timing of pegfilgrastim administration on the incidence of FN was evaluated by univariate and multivariate logistic regression analyses. Results Overall, 87 patients received a total of 318 chemotherapy cycles with pegfilgrastim, and 14 patients (16%) experienced FN. In univariate analyses, day 2 pegfilgrastim administration, age of > 65 years, baseline haemoglobin < 12 g/dL, prior history of FN, and presence of recurrent/metastatic disease trended toward an association with FN. Adjustment for these confounding risk factors revealed that day 2 pegfilgrastim administration was associated with a significantly increased risk of FN (odds ratio 11.0, p = 0.009). Conclusion Administrating pegfilgrastim on day 3 or later may prevent FN more effectively among Japanese breast cancer patients receiving intermediate-risk chemotherapies.

Keywords

Breast cancer Febrile neutropenia Intermediate-risk chemotherapies Pegfilgrastim 

Notes

Acknowledgments

The authors would like to thank T. Hirano, Dr. K. Enomoto, and Dr. Y. Hara for their valuable contribution to this work.

Funding

This study was not financially supported by any third parties.

Conflicts of interest

K Miura received speaker’s fees from Kyowa Hakko Kirin Co. Ltd., which manufactures pegfilgrastim in Japan. M. Takei received research grants from Kyowa Hakko Kirin Co. Ltd. The remaining authors have declared that they have no conflicts of interest.

References

  1. 1.
    Smith TJ, Bohlke K, Lyman GH, Carson KR, Crawford J, Cross SJ, et al. Recommendations for the use of WBC growth factors: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2015;33:3199–212.CrossRefGoogle Scholar
  2. 2.
    National Comprehensive Cancer Network (NCCN); The NCCN clinical practice guidelines in oncology: myeloid growth factors v2. 2017. October 13, 2017.Google Scholar
  3. 3.
    Weycker D, Bensink M, Lonshteyn A, Doroff R, Chandler D. Risk of chemotherapy-induced febrile neutropenia by day of pegfilgrastim prophylaxis in US clinical practice from 2010 to 2015. Curr Med Res Opin. 2017;33:2107–13.CrossRefGoogle Scholar
  4. 4.
    Shimizu T, Hirano A, Kamimura M, Ogura K, Kim N, Watanabe O, et al. A phase II study of epirubicin and cyclophosphamide followed by weekly paclitaxel with or without trastuzumab as primary systemic therapy in locally advanced breast cancer. Anticancer Res. 2010;30:4665–71.PubMedGoogle Scholar
  5. 5.
    Baselga J, Cortés J, Kim S-B, Im S-A, Hegg R, Im Y-H, et al. Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med. 2012;366:109–19.CrossRefGoogle Scholar
  6. 6.
    Masaoka T. Evidence-based recommendations for antimicrobial use in febrile neutropenia in Japan: executive summary. Clin Infect Dis. 2004;39(Suppl 1):S49–52.CrossRefGoogle Scholar
  7. 7.
    Green MD. A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy. Ann Oncol. 2003;14:29–35.CrossRefGoogle Scholar
  8. 8.
    Zwick C, Hartmann F, Zeynalova S, Poschel V, Nickenig C, Reiser M, et al. Randomized comparison of pegfilgrastim day 4 versus day 2 for the prevention of chemotherapy-induced leukocytopenia. Ann Oncol. 2011;22:1872–7.CrossRefGoogle Scholar
  9. 9.
    Loibl S, Mueller V, von Minckwitz G, Conrad B, Koehne CH, Kremers S, et al. Comparison of pegfilgrastim on day 2 vs. day 4 as primary prophylaxis of intense dose-dense chemotherapy in patients with node-positive primary breast cancer within the prospective, multi-center GAIN study: (GBG 33). Support Care Cancer. 2011;19:1789–95.CrossRefGoogle Scholar
  10. 10.
    Masuda N, Tokuda Y, Nakamura S, Shimazaki R, Ito Y, Tamura K. Dose response of pegfilgrastim in Japanese breast cancer patients receiving six cycles of docetaxel, doxorubicin, and cyclophosphamide therapy: a randomized controlled trial. Support Care Cancer. 2015;23:2891–8.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PharmacyNihon University Itabashi HospitalTokyoJapan
  2. 2.Tumor CenterNihon University Itabashi HospitalTokyoJapan
  3. 3.Departments of Breast and Endocrine SurgeryNihon University School of MedicineTokyoJapan
  4. 4.Department of Hematology and RheumatologyNihon University School of MedicineTokyoJapan

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