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).
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).
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).
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.
Asia-Pacific journal of clinical oncology. 2021 Apr [Epub]
Darren M C Poon, Kuen Chan, Tim-Wai Chan, Bryan Ng, Steven Siu, Joyce Ng, David Johnson, Ka Chai Lee, Hong Kong Society of Uro-Oncology (HKSUO)
Department of Clinical Oncology, State Key Laboratory in Oncology in South China, Sir Y.K. Pao Centre for Cancer, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong., Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong., Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong., Department of Oncology, Princess Margaret Hospital, Kowloon, Hong Kong., Department of Clinical Oncology, Queen Mary Hospital, Hong Kong Island, Hong Kong., Department of Clinical Oncology, Tuen Mun Hospital, New Territories, Hong Kong.