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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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 teacher head, 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".