Abstract | BACKGROUND: METHODS: The overall incidence of grade 3-4 (G3-4) neutropenia and FN, the time to their onset, the use of granulocyte colony-stimulating factor, and the association with risk factors were evaluated in the overall population and according to treatment arm. FN episodes were assessed by Multinational Association for Supportive Care in Cancer (MASCC) score. RESULTS: Among 1155 patients, 568 (49%) received FOLFOXIRI/ bevacizumab. Overall, 410 (35%) experienced G3-4 neutropenia and 70 (6%) FN, 21 (2%) at high risk. FOLFOXIRI/ bevacizumab was associated with higher incidence of neutropenia (51% versus 21%, P < 0.001), FN (8% versus 4%, P = 0.02), and high-risk FN [18 (3%) versus 3 (1%), P = 0.015]. No related deaths were observed. The first episode of G3-4 neutropenia and FN occurred mainly in the first 2 months in both arms. Longitudinal analysis showed different patterns of evolution over cycles between the arms (P < 0.001) G3-4 neutropenia being more frequent in the first cycles with FOLFOXIRI/ bevacizumab. Older patients (P = 0.01) and females (P < 0.001) had a significantly higher risk of G3-4 neutropenia. No significant interaction effect between arm and analysed risk factors in terms of risk of G3-4 neutropenia or FN was observed. The incidence of FN among older females receiving FOLFOXIRI/ bevacizumab was 12%. Neither G3-4 neutropenia nor FN impaired efficacy in terms of overall response rate, progression-free survival, and overall survival. CONCLUSIONS:
|
Authors | D Rossini, A Boccaccino, A Sbrana, F Daniel, B Borelli, A Raimondi, D Santini, V Conca, G Tomasello, S Caponnetto, F Marmorino, A Zaniboni, A Buonadonna, G Masi, S Lonardi, F Pietrantonio, A Falcone, A Antonuzzo, C Cremolini |
Journal | ESMO open
(ESMO Open)
Vol. 6
Issue 6
Pg. 100293
(12 2021)
ISSN: 2059-7029 [Electronic] England |
PMID | 34689001
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)
|
Copyright | Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved. |
Chemical References |
- Organoplatinum Compounds
- Bevacizumab
- Leucovorin
- Fluorouracil
- Camptothecin
|
Topics |
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects)
- Bevacizumab
(adverse effects)
- Camptothecin
(analogs & derivatives)
- Colorectal Neoplasms
(pathology)
- Febrile Neutropenia
(chemically induced, drug therapy, epidemiology)
- Female
- Fluorouracil
- Humans
- Leucovorin
- Organoplatinum Compounds
|