Abstract 5614
Background
Highly myelosuppressive chemotherapy (HMC) is the standard treatment for several types of sarcoma. Severe neutropenia is a common adverse event, which can lead to febrile neutropenia (FN) and major infections requiring hospitalization, with up to 15% mortality rate. Several trials showed an equal efficacy of filgrastim (F) and Peg-filgrastim (Peg-F) for preventing FN in many cancer types, but limited evidence is available in adult sarcoma patients (pts). We retrospectively compared the incidence of FN and hospitalization due to neutropenic infections in sarcoma pts treated with HMC with the support of either F or Peg-F.
Methods
We reviewed data of pts consecutively treated in our institution from Sep 2014 to Mar 2019. Inclusion criteria were: age >18 years; diagnosis of soft tissue sarcoma; at least 1 cycle of HMC supported by prophylactic F or Peg-F. Included HMC regimens were: doxorubicin ≥60 mg/m² (D) + ifosfamide ≥9 g/m² (IFO) +/- vincristine; high-dose IFO (≥12 g/m); IFO ≥9 g/m² + etoposide. Neutropenia prophylaxis included F (5-7 doses) or Peg-F (1 dose) according to physician‘s choice. χ2-Test was used to compare the outcomes; p ≤ 0.05 was considered significant.
Results
79 pts were found eligible, receiving 330 cycles of HMC. F and peg-F were used as prophylaxis in 66.6% (n = 220) and 33.3% (n = 110) of cases, respectively. The rate of FN was higher in the Peg-F group compared to the F group (11.8% vs 6.8, p = 0.12), while the rate of cycles complicated by a hospitalization was 9% and 3.2% (p = 0.02), respectively. 8/16 hospitalizations were due to pneumonia. One death during hospitalization occurred in the Peg-F group. 70% of hospitalizations occurred in metastatic pts, whereas 30% occurred during adjuvant treatments.
Conclusions
The use of peg-F was associated with a significantly higher rate of neutropenic infections requiring hospitalization compared with F in adult sarcoma pts receiving HMC. FN rate was numerically higher in pts receiving peg-F, not reaching statistical significance. These data suggest that F prophylaxis may be preferred in this setting to peg-F. Overall, prophylaxis with both agents provided a relatively low rate of hospitalizations and FN, compared with the myelosuppressive potential of the regimens.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1701 - Immunogenicity and optimal timing of 13-valent pneumococcal conjugate vaccination during adjuvant chemotherapy in gastric and colorectal cancer : A randomized controlled trial
Presenter: Wonyoung Choi
Session: Poster Display session 1
Resources:
Abstract
3158 - Tobacco Retail Access and Tobacco Cessation Among Head and Neck Cancer (HNC) Survivors
Presenter: Lawson Eng
Session: Poster Display session 1
Resources:
Abstract
5511 - ASSERT: A Prospective, Observational Study Measuring Sodium Improvement and Outcomes in Patients Treated for Moderate to Severe Hyponatremia Secondary to Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) in Italy (Lung Cancer Cohort)
Presenter: Rossana Berardi
Session: Poster Display session 1
Resources:
Abstract
3821 - Efficacy and safety of controlled ovarian stimulation with or without letrozole co-administration for fertility preservation: A systematic review and meta-analysis.
Presenter: Benedetta Bonardi
Session: Poster Display session 1
Resources:
Abstract
2168 - Child development at 6 years after maternal cancer diagnosis and treatment during pregnancy
Presenter: Tineke Vandenbroucke
Session: Poster Display session 1
Resources:
Abstract
5855 - Update of the registry of young women with cancer by the International Network of Cancer, Infertility and Pregnancy
Presenter: Charlotte Maggen
Session: Poster Display session 1
Resources:
Abstract
5156 - Erectile dysfunction in patients with metastatic renal cell carcinoma
Presenter: Ilya Tsimafeyeu
Session: Poster Display session 1
Resources:
Abstract
4992 - Exercise level, interest and preferences in cancer patients.
Presenter: Alice Avancini
Session: Poster Display session 1
Resources:
Abstract
3427 - Filling the Gaps in Informed Consent for Advanced Cancer Patients considering Phase 1 Oncology Trials - an in-depth Qualitative Study of Key Stakeholders at a large United Kingdom Phase 1 unit
Presenter: Abhijit Pal
Session: Poster Display session 1
Resources:
Abstract
3537 - Breast Cancer Patients’ Quality of Life: Real World Data
Presenter: Thanos Kosmidis
Session: Poster Display session 1
Resources:
Abstract