Dose Delays, Dose Reductions, and Relative Dose Intensity in Patients With Cancer Who Received Adjuvant or Neoadjuvant Chemotherapy in Community Oncology Practices

Abstract

In this large evaluation of RDI in US clinical practice, physicians frequently administered myelosuppressive agents at dose intensities lower than those of standard regimens.

Development and validation of a cycle‐specific risk score for febrile neutropenia during chemotherapy cycles 2–6 in patients with solid cancers: The CSRFENCE score

“…FN is associated with an increased risk of suboptimal treatment effect due to dose delays, dose reductions and treatment discontinuations. [1][2][3] Fortunately, mortality, morbidity and patient management associated with FN have improved with increased awareness among physicians and patients leading to prompt initiation of empiric antibiotics as advocated in clinical guidelines. 4,5 Moreover, management of FN has been reformed by risk scores.…”

Let's talk about cytotoxic chemotherapy dosing: unravelling adjustments and off‐protocol prescribing

“…In a nationwide study of United States community practices of adjuvant chemotherapy prescribing for patients with breast cancer, less than half received an RDI of at least 85% . Similar prescribing across six different types of cancers was described in another US community oncology practice review . In a trial comparing cabazitaxel with mitoxantrone for metastatic castration‐resistant prostate cancer, febrile neutropenia occurred at a higher rate in cabazitaxel‐treated patients .…”

“…18 Similar prescribing across six different types of cancers was described in another US community oncology practice review. 19 In a trial comparing cabazitaxel with mitoxantrone for metastatic castration-resistant prostate cancer, febrile neutropenia occurred at a higher rate in cabazitaxel-treated patients. 20 This study allowed GCSF prophylaxis for treatment-induced neutropenia, which is not funded by the Australian Pharmaceutical Benefits Scheme for this indication.…”

The ONE‐MIND Study: Rationale and protocol for assessing the effects of ONlinE MINDfulness‐based cancer recovery for the prevention of fatigue and other common side effects during chemotherapy

“…Side effects include fatigue, sleep disturbance, pain, nausea, vomiting and cognitive problems with memory and concentration often called “chemo brain,” or “brain fog” more generally, which collectively can significantly diminish patients′ overall quality of life (QoL) (Brandão, Schulz, & Matos, ; Carlson, Waller, Groff, Giese‐Davis, & Bultz, ; Janelsins et al, ; Schmits et al, ). CT also compromises patients’ immune systems resulting in neutropenia which increases their susceptibility to infection, and can delay subsequent CT treatments, both of which are linked to poorer therapy outcomes (Denduluri et al, ). Anxiety and depression are also common in cancer patients, as the debilitating side effects of CT can exacerbate the pre‐existing challenge of coping with a cancer diagnosis (Caruso et al, ).…”

“…. CT also compromises patients' immune systems resulting in neutropenia which increases their susceptibility to infection, and can delay subsequent CT treatments, both of which are linked to poorer therapy outcomes (Denduluri et al, 2015). Anxiety and depression are also common in cancer patients, as the debilitating side effects of CT can exacerbate the pre-existing challenge of coping with a cancer diagnosis (Caruso et al, 2017).…”