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聚乙二醇非格司亭预防剂量密集化疗的乳腺癌患者中性粒细胞减少症:德国治疗常规非干预性研究(NADENS)的结果

Prophylaxis of Neutropenia with Lipegfilgrastim in Breast Cancer Patients with Dose-Dense Chemotherapy: Results of a Noninterventional Study on Therapeutic Routine in Germany (NADENS).

作者信息

Kiechle Marion, Schem Christian, Lüftner Diana, Hipp Joachim, Stetzer Eva, Köhler Uwe

机构信息

aFrauen- und Poliklinik, Technische Universität München, Munich, Germany.

bMammazentrum Hamburg am Krankenhaus Jerusalem, Hamburg, Germany.

出版信息

Breast Care (Basel). 2022 Oct;17(5):508-513. doi: 10.1159/000524984. Epub 2022 May 11.

Abstract

INTRODUCTION

Noninterventional study (NIS) on application and effectiveness of primary G-CSF prophylaxis with lipegfilgrastim in primary breast cancer patients undergoing dose-dense (dd) or intense-dose-dense (idd) chemotherapy (CTx) regimen in daily clinical practice.

METHODS

Prospective, multicenter, single-arm, NIS in 41 private practices and 27 hospitals in Germany.

RESULTS

Data analysis of 282 patients with a mean age of 49 years (93.6% of patients <65 years) was performed. Hormone receptor status was triple negative in 29.8% of patients, and 81.9% of patients were HER2 negative. A total of 73.8% of patients received "EC dd → taxane CTx." Patients received lipegfilgrastim prophylaxis in 97.5% of 1,121 documented dd/idd cycles. Overall, the study registered 275 events of SN (CTCAE grade 3 or 4) and 9 events of FN. During the first dd cycle, SN occurred in 33.3% and FN in 1.1% of patients. CTx delay or dose reduction due to neutropenia was required in 2.5% of patients during the 4 dd cycles with lipegfilgrastim support. Overall, 314 adverse events (AEs) were reported from 107 patients and 27 serious AEs from 21 patients. None of the SAEs was "fatal," and CTCAE grade was mostly (89.6%) assessed as "1" or "2." According to the treating physicians, 99.3% of all patients benefitted from lipegfilgrastim prophylaxis, and tolerability was mostly rated "very good" or "good."

CONCLUSION

These results suggest that primary lipegfilgrastim prophylaxis is effective and safe in clinical routine and is beneficial in primary breast cancer patients undergoing dd/idd-ETC CTx.

摘要

引言

在日常临床实践中,对接受剂量密集(dd)或高强度剂量密集(idd)化疗(CTx)方案的原发性乳腺癌患者应用聚乙二醇化重组人粒细胞刺激因子(lipegfilgrastim)进行一级预防性治疗的应用情况及有效性的非干预性研究(NIS)。

方法

在德国41家私人诊所和27家医院开展的前瞻性、多中心、单臂非干预性研究。

结果

对平均年龄为49岁(93.6%的患者年龄<65岁)的282例患者进行了数据分析。29.8%的患者激素受体状态为三阴性,81.9%的患者HER2为阴性。共有73.8%的患者接受了“EC dd→紫杉烷CTx”方案。在1121个记录的dd/idd周期中,97.5%的患者接受了聚乙二醇化重组人粒细胞刺激因子预防性治疗。总体而言,该研究记录了275例严重中性粒细胞减少(CTCAE 3级或4级)事件和9例发热性中性粒细胞减少事件。在第一个dd周期中,33.3%的患者发生严重中性粒细胞减少,1.1%的患者发生发热性中性粒细胞减少。在接受聚乙二醇化重组人粒细胞刺激因子支持的4个dd周期中,2.5%的患者因中性粒细胞减少需要延迟化疗或降低剂量。总体而言,107例患者报告了314例不良事件(AE),21例患者报告了27例严重不良事件。没有严重不良事件是“致命的”,CTCAE分级大多(89.6%)被评估为“1”或“2”。根据治疗医生的评估,99.3%的患者从聚乙二醇化重组人粒细胞刺激因子预防性治疗中获益,耐受性大多被评为“非常好”或“好”。

结论

这些结果表明,在临床常规治疗中,一级聚乙二醇化重组人粒细胞刺激因子预防性治疗是有效且安全的,对接受dd/idd-ETC CTx的原发性乳腺癌患者有益。

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