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febrile neutropenia in cancer

Roberto Hegg, André Mattar, João Nunes de Matos-Neto, José Luiz Pedrini, Sabina Bandeira Aleixo, Roberto Odebrecht Rocha, Renato Peixoto Cramer-Junior, Sylvie van-Eyll-Rocha
OBJECTIVES: To compare the efficacy and safety of two filgrastim formulations for controlling chemotherapy-induced neutropenia and to evaluate the non-inferiority of the test drug relative to the originator. METHODS: This phase III non-inferiority study had a randomized, multicenter, and open-label design. The patients were randomized at a ratio of 1:1 with a follow-up period of 6 weeks for each patient. In both study arms, filgrastim was administered subcutaneously at a daily dose of 5 mg/kg body weight...
October 1, 2016: Clinics
Kim Robyn Kennedy, Assoc Prof Kirsten Auret
BACKGROUND: Febrile neutropenia is a life-threatening complication of chemotherapy. The widely dispersed population of Australia creates challenges for rural patients in accessing healthcare services. Cancer treatment is particularly burdensome with patients being forced to relocate to the city for treatment, or to endure long and repeated journeys to the city. This study aimed to assess the safety of chemotherapy in a rural centre with a General Physician-led model, by analysing febrile neutropenia in Albany Hospital, a regional cancer centre in Western Australia...
October 18, 2016: Internal Medicine Journal
M E Cazzaniga, L Cortesi, A Ferzi, L Scaltriti, F Cicchiello, M Ciccarese, S Della Torre, F Villa, M Giordano, C Verusio, M Nicolini, A R Gambaro, L Zanlorenzi, E Biraghi, L Legramandi, E Rulli
PURPOSE: The VICTOR-1 study demonstrated that the all-oral metronomic combination of vinorelbine and capecitabine is highly active and well tolerated in hormone receptor-positive/HER2-negative patients. The VICTOR-2 study was designed to confirm these results. METHODS: Patients received mVNR 40 mg three times a week and mCAPE 500 mg three times a day, continuously. The primary endpoint was the clinical benefit rate (CBR); secondary endpoints were toxicity, objective response rate (ORR), and progression-free survival (PFS)...
October 17, 2016: Breast Cancer Research and Treatment
Fausto Petrelli, Gianluca Tomasello, Michele Ghidini, Rodolfo Passalacqua, Sandro Barni
Combination of docetaxel, cisplatin, and 5-fluorouracil (DCF) is an active but not well-tolerated regimen for advanced gastric cancer (GC) with standard 3-weekly doses. Several modified schedules (mDCFs) have been designed to reduce acute toxicities and improve feasibility as first-line therapy in patients with metastatic GC. The objective of this systematic review was to evaluate overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and grade (G) greater than or equal to 3 adverse event of mDCF chemotherapy in this setting...
September 30, 2016: Anti-cancer Drugs
Stefan Fruehauf, Burkhard Otremba, Oliver Stötzer, Christine Rudolph
INTRODUCTION: Febrile neutropenia (FN) is a serious and frequent complication of cytotoxic chemotherapy. Biosimilar filgrastim (Nivestim™, Hospira Inc, A Pfizer Company, Lake Forest, IL, USA) is a granulocyte-colony stimulating factor licensed for the treatment of neutropenia and FN induced by myelosuppressive chemotherapy. The primary goal of this VENICE study ( identifier, NCT01627990) was to observe the tolerability, safety and efficacy of biosimilar filgrastim in patients receiving cancer chemotherapy...
October 14, 2016: Advances in Therapy
Derek Weycker, Xiaoyan Li, Spiros Tzivelekis, Mark Atwood, Jacob Garcia, Yanli Li, Maureen Reiner, Gary H Lyman
INTRODUCTION: Evidence suggests that many cancer chemotherapy patients who are candidates for colony-stimulating factor (CSF) prophylaxis do not receive it or receive it inconsistent with guidelines, and that such patients have a higher risk of febrile neutropenia hospitalization (FNH). Little is known about the number and consequences of FNH by use/patterns of CSF prophylaxis in US clinical practice. METHODS: A retrospective cohort design and private healthcare claims data were employed...
October 12, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
M Roskies, E Kay-Rivest, M A Mascarella, K Sultanem, A Mlynarek, M Hier
BACKGROUND: A commonly employed treatment for advanced staged oropharyngeal squamous cell carcinoma (OPSCC) is concurrent radiation and chemotherapy with cisplatin as the gold standard. Carboplatin is reported to have the same radiopotentiation properties and a superior side effect profile; however, its use in head and neck cancer has been limited due to the paucity of data and reported hematologic side effects. In this study, we describe our institution's experience with carboplatin, paclitaxel and radiation in the treatment of oropharyngeal squamous cell carcinoma over a 10 year period...
October 10, 2016: Journal of Otolaryngology—Head & Neck Surgery
Christoph Rochlitz, Martin Bigler, Roger von Moos, Jürg Bernhard, Klazien Matter-Walstra, Andreas Wicki, Khalil Zaman, Sandro Anchisi, Marc Küng, Kyung-Jae Na, Daniela Bärtschi, Markus Borner, Tamara Rordorf, Daniel Rauch, Andreas Müller, Thomas Ruhstaller, Marcus Vetter, Andreas Trojan, Ursula Hasler-Strub, Richard Cathomas, Ralph Winterhalder
BACKGROUND: Adding bevacizumab to chemotherapy improves response rates and progression-free survival (PFS) in metastatic breast cancer (mBC). We aimed to demonstrate decreased toxicity with metronomic chemotherapy/bevacizumab compared with paclitaxel/bevacizumab. METHODS: This multicenter, randomized phase III trial compared bevacizumab with either paclitaxel (arm A) or daily oral capecitabine-cyclophosphamide (arm B) as first-line treatment in patients with HER2-negative advanced breast cancer...
October 10, 2016: BMC Cancer
Giulia Pasquini, Enrico Vasile, Chiara Caparello, Caterina Vivaldi, Gianna Musettini, Monica Lencioni, Iacopo Petrini, Lorenzo Fornaro, Alfredo Falcone
PURPOSE: The aim of this study was to evaluate the activity of the combination of 5-fluorouracil/folinic acid and irinotecan (FOLFIRI) as third-line chemotherapy (CT) in metastatic gastric cancer (mGC) patients pretreated with platinum derivatives, fluoropyrimidines, and taxanes. METHODS: We prospectively collected data of mGC patients treated with third-line FOLFIRI at our institution from 2009 to 2014. Eligible patients should be treated with a fluoropyrimidine-platinum first-line CT and a subsequent taxane-based second-line CT...
October 6, 2016: Oncology
K Govind Babu, D Lokanatha, K C Lakshmaiah, M C Suresh Babu, Linu A Jacob, Gita R Bhat, Harsha Vardhana, Mahua Sinha, B R Vijaykumar, B G Sumati, R S Jayshree
INTRODUCTION: Febrile neutropenia (FN) is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. METHODS: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. OBJECTIVES: The objectives of this study were as follows: (1) To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies...
July 2016: Indian Journal of Medical and Paediatric Oncology
Rae Young Kang, Kyung Sook Yoo, Hyeon Ju Han, Ju-Yeun Lee, Se-Hoon Lee, Dong-Wan Kim, Yu Jeung Lee
PURPOSE: A weekly docetaxel regimen had comparable efficacy with a tri-weekly schedule and caused significantly less severe neutropenia and febrile neutropenia. Therefore, a weekly docetaxel regimen has become increasingly common in cancer treatment. Premedication with corticosteroids can effectively prevent or reduce the severity of hypersensitivity and fluid retention. However, no recommended steroid dosage for a weekly docetaxel regimen has been established to date. The aim of this study is to compare the efficacy and complications of two different weekly docetaxel premedication protocols...
September 30, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Toshiki Masuishi, Hiroya Taniguchi, Satoshi Hamauchi, Azusa Komori, Yosuke Kito, Yukiya Narita, Takahiro Tsushima, Makoto Ishihara, Akiko Todaka, Tsutomu Tanaka, Tomoya Yokota, Shigenori Kadowaki, Nozomu Machida, Takashi Ura, Akira Fukutomi, Masashi Ando, Yusuke Onozawa, Masahiro Tajika, Hirofumi Yasui, Kei Muro, Keita Mori, Kentaro Yamazaki
BACKGROUND: Regorafenib and trifluridine/tipiracil (TAS-102) both prolong survival for patients with refractory metastatic colorectal cancer. However, it is unclear which drug should be administered first. MATERIALS AND METHODS: We retrospectively evaluated the data from patients who had received regorafenib or TAS-102 at 2 institutions from May 2013 to March 2015. The inclusion criteria were disease refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, anti-vascular endothelial growth factor antibodies, and anti-epidermal growth factor receptor (EGFR) antibodies (if KRAS exon 2 wild-type), and no previous treatment with regorafenib or TAS-102...
August 31, 2016: Clinical Colorectal Cancer
John Hilton, Sasha Mazzarello, Dean Fergusson, Anil A Joy, Andrew Robinson, Angel Arnaout, Brian Hutton, Lisa Vandermeer, Mark Clemons
PURPOSE: The current clinical trials development and conduct process is cumbersome and expensive, with the majority of studies focusing on either the development of new agents or new indications for established agents. Unfortunately, research comparing standard-of-care interventions is rarely performed, leaving many important and practical patient-centered questions unanswered. Novel clinical trial methodologies and approaches are needed. METHODS: We have identified simple key components that, when combined, enhance the ability to both perform and increase accrual for studies that compare standard-of-care interventions...
September 20, 2016: Journal of Oncology Practice
Wanda Liguigli, Gianluca Tomasello, Laura Toppo, Rossana Poli, Silvia Lazzarelli, Federica Negri, Bruno Perrucci, Alessandra Curti, Matteo Brighenti, Gianvito Donati, Morena Nazzari, Mario Martinotti, Marco Vismarra, Massimo Rovatti, Rodolfo Passalacqua
PURPOSE: To evaluate the efficacy and safety of dose-dense TCF in elderly (≥65 years) compared to younger patients. METHODS: Safety and efficacy data relative to 119 consecutive patients with locally advanced or metastatic gastric cancer treated at our institution and enrolled in different phase II trials were retrospectively collected. All patients were treatment-naive and received docetaxel 70 mg/m2 day 1, cisplatin 60 mg/m2 day 1, l-folinic acid 100 mg/m2 days 1-2, followed by 5-fluorouracil 400 mg/m2 bolus days 1-2, and then 600 mg/m2 as a 22-hour continuous infusion days 1-2, every 14 days, plus pegfilgrastim 6 mg on day 3...
August 23, 2016: Tumori
Rami Jalal Yaghan, Nawaf Mahmood Dagher
BACKGROUND: In the adjuvant treatment of breast cancer, anthracycline and taxane based regimens can be used concomitantly or sequentially. The best order in the sequential regimens has yet to be well established. This study evaluated the feasibility of 4 cycles of adjuvant taxotere (100mg/m2) every 3 weeks followed by 4 cycles of doxorubicin (60 mg/m2) and cyclophosphamide (600mg/m2) every 3 weeks. The primary outcome was the safety profile. Secondary outcomes were disease free survival (DFS) and overall survival (OS)...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Seiji Mabuchi, Eriko Yokoi, Takao Owa, Katsumi Kozasa, Michiko Yamashita, Eiji Kobayashi, Takuji Tomimatsu, Takeshi Yoki, Tateki Tsutui, Tadashi Kimura
OBJECTIVES: This study aimed to determine the maximum tolerated dose and acute dose-limiting toxicities (DLTs) of intravenous irinotecan plus oral S-1 in patients with advanced or recurrent uterine cervical cancer. METHODS: Irinotecan was administered intravenously over the course of 90 minutes on day 1, and S-1 was given orally in 2 divided doses from days 1 to 14 of a 21-day cycle. The dose of S-1 was escalated in a stepwise fashion from 40 (level 1) to 60 mg/m (level 2) and then 80 mg/m (level 3), whereas the dosage of irinotecan remained the same (150 mg/m)...
September 2016: International Journal of Gynecological Cancer
Pamala A Pawloski, Avis J Thomas, Sheryl Kane, Gabriela Vazquez-Benitez, Gary R Shapiro, Gary H Lyman
OBJECTIVES: Clinical guidelines recommending the use of myeloid growth factors are largely based on the prescribed chemotherapy regimen. The guidelines suggest that oncologists consider patient-specific characteristics when prescribing granulocyte-colony stimulating factor (G-CSF) prophylaxis; however, a mechanism to quantify individual patient risk is lacking. Readily available electronic health record (EHR) data can provide patient-specific information needed for individualized neutropenia risk estimation...
September 16, 2016: Journal of the American Medical Informatics Association: JAMIA
Romain Guilhaumou, Amélie Marsot, Julien Dupouey, Claire Galambrun, Audrey Boulamery, Carole Coze, Nicolas Simon, Nicolas André
BACKGROUND: In pediatric cancer patients, determination of optimal vancomycin dosage is essential because of high risk of inadequate concentrations and bacterial resistance. The aim of this study was to determine vancomycin pharmacokinetic parameters in this population and propose dosage optimization to achieve optimal concentration. METHODS: We retrospectively reviewed the use of vancomycin in pediatric cancer patients with febrile neutropenia (hematological or solid tumor disease)...
October 2016: Therapeutic Drug Monitoring
Marek Z Wojtukiewicz, Ewa Sierko, Piotr Skalij, Magda Kamińska, Lech Zimnoch, Ralf A Brekken, Philip E Thorpe
BACKGROUND: Doxorubicin and docetaxel-based chemotherapy regimens used in breast cancer patients are associated with high risk of febrile neutropenia (FN). Granulocyte colony-stimulating factors (G-CSF) are recommended for both treating and preventing chemotherapy-induced neutropenia. Increased thrombosis incidence in G-CSF treated patients was reported; however, the underlying mechanisms remain unclear. The principal activator of blood coagulation in cancer is tissue factor (TF). It additionally contributes to cancer progression and stimulates angiogenesis...
May 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Hirotsugu Yanai, Kayoko Endo, Mayumi Matsumoto, Masanori Kon, Tomoharu Sugie
BACKGROUND: More than 20%of breast cancer patients who undergo myelosuppressive chemotherapy involving FEC(100) or TC experience febrile neutropenia(FN), and pegfilgrastim is commonly recommended as the primary prophylaxis. Delays and/or dose-reductions in chemotherapy should be avoided as much as possible to maximize the clinical benefits of these adjuvant chemotherapies. PURPOSE: This study assessed the relative dose intensity(RDI), efficacy, and safety of pegfilgrastim in patients with breast cancer...
September 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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