Clinical predictors of failure of granulocyte colony stimulating factor (G-CSF) prophylaxis in patients with breast cancer treated with dose dense epirubicin (E), cyclophosphomide (C) + paclitaxel (T) Adjuvant chemotherapy: Subgroup analysis of the NCIC CTG MA.21 study (NCT00014222).
Bibliographic record
Abstract
1033 Background: Administration of prophylactic GCSF is recommended for curative chemotherapy regimens with an estimated incidence of febrile neutropenia of ≥ 20% (Smith et al.,JCO 24:3187-3205, 2006). Clinical predictors of failure of prophylaxis are poorly understood. Methods: We retrospectively analyzed data pertaining to patients treated with dose dense EC-T chemotherapy (E: 120 mg/m2 IV Day 1 + C: 830 mg/m2 IV Day 1, q14days x 6 cycles followed by T: 175 mg/m2 IV q21days x 4 cycles) and primary prophylaxis with GCSF (5 µg/kg subcutaneously, days 2-13) on the NCIC CTG MA21 phase III study which compared 3 different anthracycline based chemotherapy regimens. An interim analysis has been published (Burnell et al., JCO, 2010). Results: 695 patients were randomized to the EC-T arm and received at least one dose of protocol therapy and primary GCSF prophylaxis. 139 (20.0%) patients experienced a febrile neutropenic event; of which 46 (33.1%) were hospitalized. There were no deaths secondary to febrile neutropenia. In a multivariate analysis, no significantly detrimental role of the covariates, including the ones listed, were identified. Conclusions: In the context of the MA.21 study, the failure rate of primary prophylaxis with GCSF therapy for prevention of febrile neutropenia in patients treated with dose dense EC-T therapy was 20% with an associated hospitalization rate of 30%. In multivariate analysis, none of the patient variables analyzed was significantly associated with failure of GCSF prophylaxis. Selected Covariates OR 95% CI P-Value Age 0.997 0.958 - 1.038 0.883 BMI 0.995 0.966 - 1.025 0.741 Diabetes 1.597 0.42 - 6.07 0.492 Liver Disease 1.335 0.149 - 11.94 0.796 Menopausal Status 1.152 0.559 - 2.215 0.672 Performance Status 1.21 0.661 - 2.214 0.537
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".