Hayama Tatsuya, Sakurai Kenichi, Miura Katsuhiro, Washinosu Shinsaku, Tsuboi Shinya, Uchiike Akihiro, Yoshida Yoshikazu, Takei Masami
Department of Pharmacy, Nihon University Itabashi Hospital, Tokyo, Japan.
Tumor Center, Nihon University Itabashi Hospital, 30-1 Oyaguchikamicho, Itabashi ward, Tokyo, 173-8610, Japan.
Int J Clin Pharm. 2018 Oct;40(5):997-1000. doi: 10.1007/s11096-018-0667-z. Epub 2018 Jun 1.
Background Pegfilgrastim is widely used for prophylaxis of febrile neutropenia (FN) in cancer patients receiving chemotherapies. However, the optimal timing of pegfilgrastim administration has not been established. Objective We investigated the effect of the timing of pegfilgrastim administration on the prevention of FN in patients with breast cancer undergoing intermediate-risk chemotherapies. Method We retrospectively analysed the incidence of FN in patients with breast cancer treated at our institution with intermediate-risk chemotherapies and primary or secondary prophylactic pegfilgrastim between 2015 and 2017. The impact of the timing of pegfilgrastim administration on the incidence of FN was evaluated by univariate and multivariate logistic regression analyses. Results Overall, 87 patients received a total of 318 chemotherapy cycles with pegfilgrastim, and 14 patients (16%) experienced FN. In univariate analyses, day 2 pegfilgrastim administration, age of > 65 years, baseline haemoglobin < 12 g/dL, prior history of FN, and presence of recurrent/metastatic disease trended toward an association with FN. Adjustment for these confounding risk factors revealed that day 2 pegfilgrastim administration was associated with a significantly increased risk of FN (odds ratio 11.0, p = 0.009). Conclusion Administrating pegfilgrastim on day 3 or later may prevent FN more effectively among Japanese breast cancer patients receiving intermediate-risk chemotherapies.
培非格司亭广泛用于接受化疗的癌症患者预防发热性中性粒细胞减少症（FN）。然而，培非格司亭给药的最佳时机尚未确定。目的：我们研究了培非格司亭给药时机对接受中度风险化疗的乳腺癌患者预防FN的影响。方法：我们回顾性分析了2015年至2017年间在我院接受中度风险化疗及一级或二级预防性培非格司亭治疗的乳腺癌患者的FN发生率。通过单因素和多因素逻辑回归分析评估培非格司亭给药时机对FN发生率的影响。结果：总体而言，87例患者共接受了318个含培非格司亭的化疗周期，14例患者（16%）发生了FN。在单因素分析中，第2天给予培非格司亭、年龄>65岁、基线血红蛋白<12 g/dL、既往FN病史以及存在复发/转移疾病与FN存在关联趋势。对这些混杂风险因素进行校正后发现，第2天给予培非格司亭与FN风险显著增加相关（比值比11.0，p = 0.009）。结论：在接受中度风险化疗的日本乳腺癌患者中，在第3天或更晚给予培非格司亭可能更有效地预防FN。
