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

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.
AuthorsGiuseppe Frasci
JournalDrugs (Drugs) Vol. 62 Suppl 1 Pg. 17-31 ( 2002) ISSN: 0012-6667 [Print] New Zealand
PMID12479592 (Publication Type: Journal Article, Review)
Chemical References
  • Antineoplastic Agents
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Filgrastim
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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