Incidence of Febrile Neutropenia with Taxane-Based Systemic Therapy in Women with Early Stage Breast Cancer.
Bibliographic record
Abstract
Abstract Background: Febrile neutropenia (FN) is one of the most significant toxicities experienced by patients treated with systemic therapy. Taxanes now play an integral role in the systemic therapy for women with early stage breast cancer. The most common taxane-containing regimen utilized in Ontario, Canada is 5-Fluorouracil/Epirubicin/Cyclophosphamide x 3 followed by Docetaxel x 3 (FEC-D). PACS 01 reported a febrile neutropenia (FN) rate of 11.2% in the FEC-D arm. In our clinical practice, clinicians have noted a much higher rate of FN. We report the FN rate with the use of FEC-D in women with early stage breast cancer treated at tertiary care centers in Ontario.Methods: All women with early stage breast cancer who were treated with FEC-D from three tertiary care cancer centers in Ontario, Canada (London, Sudbury, Ottawa) between June 2006 and December 2008 were included in this retrospective analysis. Data included: demographics, staging, hormone receptor status, primary prophylaxis use with growth factors, FN rate, admission to hospital and duration of hospital admission.Results: Median age of 630 women is 52 years (r: 24-77). Staging was: I (88), IIA (243), IIB (159), IIIA (94), IIIB (23), IIIC (14) and 9 unknown. A total of 474 (75.2%) were ER positive. Primary prophylaxis with growth factor support was given to 222 patients (35%) and 408 patients (65%) did not have upfront prophylaxis. Of the 222 patients who were given primary prophylaxis, 14 patients (6.3%) were diagnosed with FN. Of the 408 patients who did not receive primary prophylaxis, 120 patients (29.4%) were diagnosed with FN. All patients (n=120) diagnosed with FN received secondary prophylaxis with growth factor support. A total of 126 patients (20%) were admitted to hospital for FN. The median duration of hospital admission was 3.9 days (r: 1-65 days). The impact of risk factors, the use of filgastrim versus pegylated filgastrim on FN rates and the clinical ramifications of febrile neutropenia (ICU admissions/deaths) will be reported.Conclusions: The results of this retrospective analysis demonstrate a much higher risk of FN (29.4%) with FEC-D than has been previously reported. More complete reporting of primary prophylaxis is required. This rate of FN would warrant use of primary prophylaxis for patients prescribed FEC-D, particularly in high risk subgroups. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2087.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".