Abstract P5-10-24: A Pragmatic Review of Adjuvant Chemotherapy Regimens in Early-Stage Breast Cancer — Hematologic Toxicities Experienced in a Single Institution
Bibliographic record
Abstract
Abstract Background: Chemotherapy-related toxicities are associated with substantial morbidity, mortality, and health care expenditures. Three newer common adjuvant chemotherapy regimens - 5-fluorouracil, epirubicin, cyclophosphamide plus docetaxel (FEC-D), docetaxel plus cyclophosphamide (TC), and docetaxel, carboplatin plus trastuzumab (TCH) - have emerged as promising therapies. The toxicities experienced with these chemotherapeutic regimens were reviewed in a clinical practice setting outside of clinical trial. Patients and Methods: Patients (pts) with early-stage breast cancer treated with adjuvant chemotherapy (FEC-D; TC; TCH) at St. Michael's Hospital in Toronto, Canada, between August 2006 and May 2010 were identified. Charts were audited for the presence of neutropenia (defined asabsolute neutrophil count (ANC) < 1.0x109/L), use of granulocyte-colony stimulating factor (G-CSF), incidence of febrile neutropenia (FN; defined as a single oral temperature ≥38.3 0Celsius, or oral temperature ≥38.0 0C lasting over 1 hour, with an ANC < 1.0x109/L). Results: Overall, 175 pts were reviewed in this study. The rate of neutropenia, FN, and use of primary prophylaxis with G-CSF are summarized in the table below for each regimen. Thirty pts on FEC-D (25.2%) experienced significant complications resulting in dose delay, dose reduction, and discontinuation of chemotherapy, as did 9.1% of pts on TC, and 27.3% of pts on TCH. There was one death associated with FEC-D while on G-CSF. Conclusion: Our institution reports FN rates higher than originally reported in all three chemotherapy regimens with a greater hematologic toxicity profile with FEC-D. Further investigation with larger patient cohorts is warranted, to determine if there is a need for primary prophylaxis with G-CSF in patients receiving FEC-D, TC, and TCH. Table 1: Outcomes associated with FEC-D, TC, and TCH chemotherapy regimens Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-10-24.
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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 | 0.013 | 0.035 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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".