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E-Poster Display

1837P - Febrile neutropenia (FN) primary prophylaxis (1º Prlx) with platinum and etoposide (P&E) chemotherapy (ChT) regimens: Some action needed


17 Sep 2020


E-Poster Display


Supportive Care and Symptom Management

Tumour Site


Ana Spencer


Annals of Oncology (2020) 31 (suppl_4): S988-S1017. 10.1016/annonc/annonc291


A.S. Spencer, A.F. Palma dos Reis, A. Parmanande, J.V. Barreira, D. Simão, M. Sardinha, J. Mendes, A. Machado, P.W. Pereira, R. Luz

Author affiliations

  • Medical Oncology, Centro Hospitalar de Lisboa Central (CHLC)-Hospital de Santo António dos Capuchos (HSAC), 1169-050 - Lisbon/PT


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Abstract 1837P


P&E ChT regimens are considered of intermediate risk for FN (10-20%). Guidelines state G-CSF 1º prlx in this context relies on clinical judgment, concerning patients’ (pts) age (> 65 years) and comorbidities. Acknowledging actual FN rates and pts’ characteristics are key to ensure treatment (tx) safety and relative dose intensity. This study aimed to describe FN events with P&E in a real-world setting.


We performed a retrospective analysis of all pts treated with at least 1 cycle (C) of Cisplatin or Carboplatin and Etoposide at our Institution, throughout the last 6 years (y).


From January 1st 2013 to July 10th 2019, 78 pts were submitted to at least 1C of P&E, the majority having small cell lung cancer [(SCLC; 51(65.4%)]. A Carboplatin doublet was given to 45 pts(58%). At least 1 FN event occurred in 16(21%) pts, the majority 13/16(81%) on a Carboplatin doublet. Nine pts were over 65 y, 4 on prolonged corticotherapy, 2 with chronic obstructive pulmonary disease, 1 hemodialysed and 1 with pre-tx liver dysfunction (total bilirubin >2mg/dl). No other risk factors were found in 5/16(31%) FN pts. 2/16 received G-CSF 1º prlx. FN grade 5 toxicity occurred in 4/78(5%) pts.


For a median follow-up of 36 months (30.7-41.2), P&E FN rates in our population reached 21%, exceeding the high-risk FN boundary with a non-negligible grade 5 toxicity. Despite sample size limitations, our results suggest G-CSF 1º prlx should be considered more often in order to prevent serious P&E ChT-related infections. Carboplatin-based regimens should draw special attention concerning the higher myelosuppressive potential and preferential choice in Cisplatin-ineligible or stage IV SCLC pts, whose comorbidities frequently increase the FN risk. Further prospective data are needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.


Has not received any funding.


All authors have declared no conflicts of interest.

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