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Impact of G-CSF Prophylaxis on Chemotherapy Dose-Intensity, Link Between Dose-Intensity and Survival in Patients with Metastatic Pancreatic Adenocarcinoma.
- Source :
- Oncologist; Jul2022, Vol. 27 Issue 7, pe571-e579, 9p, 1 Diagram, 4 Charts, 1 Graph
- Publication Year :
- 2022
-
Abstract
- Background In metastatic pancreatic adenocarcinoma, few data are available on the use of granulocyte-colony stimulating factor (G-CSF) prophylaxis and its impact on dose-intensity (DI), or the link between DI and progression-free survival (PFS). This study assessed the impact of G-CSF prophylaxis on the DI received by patients and the relationship between full DI and PFS according to chemotherapy regimens. Patients and Methods Patients from three first-line randomized phase II clinical trials were included in this retrospective cohort. G-CSF prophylaxis groups were identified and balanced according to baseline characteristics using a propensity score. Patients were classified into 2 treatment groups (FOLFIRINOX vs FOLFIRI/nab-paclitaxel (NAB)). DI was a binary variable (full/reduced). Adverse events were defined using NCI-CTCAE v4.0. Results Of the 498 patients, 154 (31%) were in "prophylaxis" group; 179 (36%) were treated by FOLFIRINOX and 319 (64%) by FOLFIRI/NAB. In FOLFIRINOX group, G-CSF prophylaxis was significantly associated with a higher rate of full DI (OR, 5.07; 95% CI, 1.52-16.90; P <.01) while in FOLFIRI/NAB group, it was significantly associated with a lower rate of full DI (OR, 0.23; 95% CI, 0.06-0.83; P =.03). Full DI was associated with a non-significant increase in PFS (FOLFIRINOX group: HR 0.83; 95% CI, 0.59-1.16; P =.27; FOLFIRI/NAB group: HR 0.84; 95% CI, 0.63-1.11; P =.22). Conclusion Granulocyte-colony stimulating factor prophylaxis was associated with a higher rate of full DI with FOLFIRINOX. Full DI was associated with a non-significant increase in PFS. These results need to be confirmed prospectively. [ABSTRACT FROM AUTHOR]
- Subjects :
- PANCREATIC tumors
ADENOCARCINOMA
GRANULOCYTE-colony stimulating factor
CONFIDENCE intervals
CANCER chemotherapy
ANTINEOPLASTIC agents
METASTASIS
NEUTROPENIA
RETROSPECTIVE studies
CANCER patients
KAPLAN-Meier estimator
DESCRIPTIVE statistics
DRUG side effects
ODDS ratio
CHEMOPREVENTION
PROPORTIONAL hazards models
Subjects
Details
- Language :
- English
- ISSN :
- 10837159
- Volume :
- 27
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Oncologist
- Publication Type :
- Academic Journal
- Accession number :
- 158429047
- Full Text :
- https://doi.org/10.1093/oncolo/oyac055