Primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) may modestly reduce neutropenia-related hospitalization in patients with breast cancer receiving docetaxel and cyclophosphamide or docetaxel, carboplatin, and trastuzumab, according to a study published in the Journal of Clinical Oncology.1

For the study, investigators analyzed data from 8745 adult patients included in a medical and pharmacy claims database. All patients had received a breast cancer diagnosis and had begun the first cycle of chemotherapy between 2008 and 2013. Chemotherapy regimens included docetaxel plus cyclophosphamide, docetaxel plus carboplatin and trastuzumab, and doxorubicin plus cyclophosphamide.

The rate of neutropenia, fever, or infection-related hospitalization within 21 days of beginning chemotherapy among patients who received primary G-CSF prophylaxis, defined as administration within 5 days of initiating chemotherapy, was compared with that of those who did not receive primary prophylaxis.

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Results showed that primary prophylaxis was associated with a reduced risk of neutropenia-related hospitalization among patients receiving docetaxel plus cyclophosphamide and those given docetaxel plus carboplatin and trastuzumab.

However, the rate of neutropenia-related hospitalization was similar for patients who received doxorubicin and cyclophosphamide regardless of the receipt of primary prophylaxis.

Researchers found that 18 patients would have to be treated with docetaxel and cyclophosphamide or docetaxel, carboplatin, and trastuzumab to prevent 1 neutropenia-related hospitalization vs 21 patients treated with doxorubicin and cyclophosphamide.

The authors note that further assessment is necessary to better understand which patients would benefit most from primary G-CSF prophylaxis.


1. Agiro A, Ma Q, Acheson AK, et al. Risk of neutropenia-related hospitalization in patients who received colony-stimulating factors with chemotherapy for breast cancer. J Clin Oncol. 2016 Sep 19. doi: 10.1200/JCO.2016.67.2899.