Febrile neutropenia rates with adjuvant docetaxel and cyclophosphamide chemotherapy in early breast cancer: discrepancy between published reports and community practice—an updated analysis

J. Younus, T. Vandenberg, M. Jawaid, M.A. Jawaid


Chemotherapy in the adjuvant setting for early breast cancer (ebc) has improved disease-free and overall survival, with benefits extended to elderly patients and to those with lymph-node-negative pathology1,2. Recent clinical trials have largely supported the additional benefit of taxane therapy, including benefit in older patients3. The increase in the proportion of women treated and the improved survival mean that toxicities become increasingly important. One of the most serious acute toxicities is febrile neutropenia (fn). An updated U.S. Oncology trial report has demonstrated benefit in disease-free and overall survival for 4 cycles of docetaxel–cyclophosphamide (tc) chemotherapy over doxorubicin cyclophosphamide chemotherapy and has also reported acceptable toxicity, with a fn rate of 5%4. The tc regimen has become very popular in Ontario, particularly in older age groups who are at increased risk of cardiotoxicity with anthracyclines and in patients eligible for trastuzumab5. We previously published our experience with ebc patients treated with tc chemotherapy and the incidence of fn6. Here, we present our updated and expanded data examining the incidence of fn related to the use of tc chemotherapy in the adjuvant setting in ebc at the London Regional Cancer Program.

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DOI: http://dx.doi.org/10.3747/co.19.1174

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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)