Risk Factors for Febrile Neutropenia Induced by Docetaxel Chemotherapy in Patients with Non-small Cell Lung Cancer

Abstract

We retrospectively obtained data of patient background and pretreatment characteristics from medical records and identified the predictive factors of febrile neutropenia (FN) in patients with non-small cell lung cancer (NSCLC) treated with docetaxel alone or in combination with the anti-vascular endothelial growth factor (VEGF) antibody bevacizumab. Patients were eligible for inclusion in the study if they were 20 years or older, diagnosed with NSCLC, and received docetaxel monotherapy alone or in combination with bevacizumab at the Department of Respiratory Medicine, Kobe City Medical Center General Hospital, between July 1, 2011, and March 31, 2018. Eighty-one patients with recurrent or advanced NSCLC were included. Multivariate stepwise logistic regression analysis with backward selection revealed that lower baseline Eastern Cooperative Oncology Group performance status (ECOG-PS) scores of 1 and 2 (odds ratio (OR), 5.098; 95% confidence interval (CI), 1.045-24.879, p 0.021) and baseline platelet count below 18.8 10 4 /µL (OR, 3.861; 95% CI, 1.211-12.311, p 0.022) were significant factors influencing the FN occurrence rate. Our results demonstrated that ECOG-PS 1-2 and lower baseline platelet count were significant risk factors of FN in patients with NSCLC receiving docetaxel-based chemotherapy. Moreover, the combination of anti-VEGF antibodies and docetaxel might be associated with increased FN frequency. Despite the limitations of this study including its retrospective design, single-center site, and small sample size, baseline ECOG-PS score and platelet count may be regarded as important indices to identify patients for prophylactic granulocytecolony stimulating factor (G-CSF) treatment before docetaxel-based chemotherapy.

Optimal exposure to docetaxel in adjuvant chemotherapy for early‐stage breast cancer

“…Similar to the previous studies, 37,38 the absence of platinum use and low haemoglobin levels were associated with higher neutropenia risk. The small number of patients and single center are the major limitations of this study, which may lead to some bias.…”

“…34 In our study and in the study by Wang, 35 the median and mean docetaxel AUCs of patients with grade 3/4 neutropenia were 3.3 and 2.8 mg h/L, respectively, whereas the mean docetaxel AUC of European patients was 4.4 mg h/L. 16 Similar to the previous studies, 37,38 the absence of platinum use and low haemoglobin levels were associated with higher neutropenia risk. The small number of patients and single center are the major limitations of this study, which may lead to some bias.…”

Detection of factors related to treatment reduction in docetaxel and ramucirumab for non-small cell lung cancer treatment

“…There is no report evaluating factors associated with the overall severe adverse effects inducing treatment reduction in DOC + RAM; however, there are some studies regarding FN in DOC monotherapy. Uchida et al have reported that higher baseline hemoglobin levels could be associated with FN development in patients with NSCLC, although it was not assessed in multivariate analysis owing to the small patient population (unadjusted odds ratio 1.34; 95% confidence interval, 0.99-1.88; P = 0.06) 23 . In contrast, Hirasawa et al and Kwon et al reported that baseline hemoglobin levels are not associated in patients with castration-resistant prostate cancer 8,9 .…”

<i>Astragalus</i> Polysaccharide Suppresses Cell Proliferation and Invasion by Up-Regulation of miR-195-5p in Non-small Cell Lung Cancer

“…Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancer-related mortality, 9) and early metastasis is the main cause of deaths from the disease. 10,11) Combined with a plastic and responsive microenvironment, random epigenetic and genetic mutations in cancer support the metastatic evolution of tumors. 12) Currently among tested molecular factors in lung cancer patients, differential expression and regulation of microRNA (miRNA) molecules seem to be the most attractive.…”