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.
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All authors have declared no conflicts of interest.