Prevention of docetaxel‐associated febrile neutropenia with primary granulocyte colony‐stimulating factor in Chinese metastatic hormone‐sensitive and castration‐resistant prostate cancer patients

• Published in: Asia-Pacific journal of clinical oncology Vol. 17; no. S3; pp. 39 - 47
• Main Authors: Poon, Darren M.C., Chan, Kuen, Chan, Tim‐Wai, Ng, Bryan, Siu, Steven, Ng, Joyce, Johnson, David, Lee, Ka Chai
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.04.2021
• Subjects: Adult; Aged; Aged, 80 and over; Castration; China; Cohort Studies; Colonies; Disease prevention; docetaxel; Docetaxel - adverse effects; febrile neutropenia; Febrile Neutropenia - chemically induced; Granulocyte Colony-Stimulating Factor - therapeutic use; granulocyte colony‐stimulating factor; Granulocytes; Humans; Leukocytes (granulocytic); Male; Metastases; Metastasis; Middle Aged; Neutropenia; Oncology; Prophylaxis; Prostate cancer; Prostatic Neoplasms, Castration-Resistant - complications; Prostatic Neoplasms, Castration-Resistant - drug therapy; Retrospective Studies; China; prostate cancer; febrile neutropenia; granulocyte colony-stimulating factor; docetaxel; metastasis
• DOI: 10.1111/ajco.13578
• ISSN: 1743-7555

Introduction Asian prostate cancer (PC) patients are particularly susceptible to docetaxel‐related febrile neutropenia (FN). We evaluated primary granulocyte colony‐stimulating factor (GCSF) for preventing FN in Chinese patients with metastatic hormone‐sensitive PC (mHSPC) and castration‐resistant PC (mCRPC). Patients and Methods Data from two cohorts of 377 Chinese patients with mHSPC (100; 26.5%) and mCRPC (277; 73.5%) treated with docetaxel at six public oncology centres were analysed with multivariate regression. Primary GCSF prophylaxis was defined as administration within 5 days of starting docetaxel. The primary outcome was FN within 21 days of the first docetaxel cycle (1st FN). Results Primary GCSF was given to 71 (18.8%) patients. FN occurred in 61 patients (16.2%) including 37 (9.8%) during the first cycle. Among patients who developed 1st cycle FN (n = 37) or not (n = 340), 2 and 69 received primary GCSF (5.4 vs. 20.3%, P = .03). Primary GCSF was associated with an overall reduced risk of 1st cycle FN (odds ratio [OR] = 0.22; 95% confidence interval [CI]: 0.05‐0.96, P = .04), and similar trends were observed in the mHSPC (OR = 0.36, P = .35) and mCRPC (OR = 0.16, P = .08) subgroups. Poor Eastern Cooperative Oncology Group performance status (>1) was associated with an increased risk of 1st FN (OR = 3.90; 95% CI: 1.66‐9.13, P = .002). Conclusions To alleviate the risk of docetaxel‐related FN, primary GCSF prophylaxis is suggested for Asian mCRPC and mHSPC patients, particularly those with poor performance status.