Saito Hiroshi, Takahashi Kosuke, Okuno Motoyasu, Saka Hideo, Imaizumi Kazuyoshi, Hasegawa Yoshinori, Tanikawa Yoshimasa, Yamamoto Masashi, Taniguchi Hiroyuki, Shindoh Joe, Suzuki Ryujiro, Shimokata Kaoru
Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki, Japan.
J Infect Chemother. 2014 Jun;20(6):365-9. doi: 10.1016/j.jiac.2014.02.002. Epub 2014 Mar 26.
We assessed the efficacy and safety of cefepime monotherapy (1 g intravenously every 8 h) for febrile neutropenia in patients with lung cancer in a multi-institutional phase II study. Patients treated with chemotherapy with or without radiotherapy for lung cancer were eligible for this study. Other eligibility criteria included fever (temperature of ≥38.0 °C) and an absolute neutrophil count of <500/mm(3) or <1000/mm(3) with an expected decline to <500/mm(3) within the next 48 h. Risk assessment was performed using the Multinational Association of Supportive Care in Cancer risk-index score. Cefepime 1 g was given intravenously every 8 h. The primary endpoint was the response rate at the end of cefepime therapy. Co-administration of granulocyte-colony-stimulating factor was permitted. Of 54 patients enrolled, 39 were classified in the low-risk group and 15 in the high-risk group. Overall response rate was 78% (95% CI: 64.4-88.0%). The response rates were 85% (95% CI: 69.5-94.1%) in the low-risk group and 60% (95% CI: 32.3-83.7%) in the high-risk group, respectively. One patient died from septic shock due to Enterobacter cloacae bacteremia. There was no significant adverse event. Cefepime 1 g intravenously every 8 h appears to be effective for febrile neutropenia in patients with lung cancer, especially in those with low-risk febrile neutropenia, and is well tolerated.
UMIN Clinical Trials Registry, UMIN000006157.
