Treatment of breast cancer with chemotherapy in combination with filgrastim: Approaches to improving therapeutic outcome

Research output: Contribution to journalArticlepeer-review

Abstract

Chemotherapy improves disease-free and overall survival in breast cancer, and its benefit is directly related to the percentage of the planned dose that is actually administered. In all current chemotherapeutic regimens, a substantial proportion of patients have reductions and/or delays in dosage due to side effects. In about half such cases, the delays or reductions are related to neutropenia. Overall, approximately 30% of patients have a reduction to less than 85% of the planned dosage. Women aged ≥50 years are more likely to experience a reduction or delay in dose. Dose-intense regimens (excluding myeloablative high-dose chemotherapy) which increase the dose of chemotherapy or reduce the interval between cycles, or both, are a promising approach now under investigation. The human granulocyte colony-stimulating factor filgrastim reduces the incidence of neutropenia and facilitates adherence to full dose intensity in both standard and dose-intensified regimens. A model based on the first-cycle absolute neutrophil count nadir has been developed and validated to determine which patients should receive filgrastim. A cost benefit as sociated with the use of filgrastim in patients with breast cancer has been realised. This may lead to a re-evaluation of the current treatment guidelines.

Original languageEnglish
Pages (from-to)17-31
Number of pages15
JournalDrugs
Volume62
Issue numberSUPPL. 1
Publication statusPublished - 2002

ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Toxicology

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