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 > or = 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 associated 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.
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Authors | Giuseppe Frasci |
Journal | Drugs
(Drugs)
Vol. 62 Suppl 1
Pg. 17-31
( 2002)
ISSN: 0012-6667 [Print] New Zealand |
PMID | 12479592
(Publication Type: Journal Article, Review)
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Chemical References |
- Antineoplastic Agents
- Recombinant Proteins
- Granulocyte Colony-Stimulating Factor
- Filgrastim
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Topics |
- Antineoplastic Agents
(administration & dosage, adverse effects, therapeutic use)
- Breast Neoplasms
(drug therapy, economics, mortality)
- Cost-Benefit Analysis
- Drug Therapy, Combination
- Female
- Filgrastim
- Granulocyte Colony-Stimulating Factor
(economics, therapeutic use)
- Humans
- Neutropenia
(chemically induced, prevention & control)
- Recombinant Proteins
- Survival Rate
- Treatment Outcome
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