Author of

• 20179

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  P2.15 - SCLC/Neuroendocrine Tumors (ID 716)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: SCLC/Neuroendocrine Tumors
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23529

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    P2.15-014 - Extensive Stage Small Cell Lung Cancer: Is Primary Growth Factor Support Warranted in Patients Having Doublet Chemotherapy? (ID 9176)

    09:30 - 09:30  |  Author(s): C. Jacobs
    • Abstract

    Background:
    Currently the chemotherapy protocol for extensive stage small cell lung cancer at Auckland Regional Cancer and Blood Service does not include a recommendation for the use of growth colony stimulating factor (G-CSF) support as either primary prophylaxis or in the secondary setting. The protocol does provide guidelines for treatment delay and dose reduction in the setting of haematological toxicity. Access to publicly funded pegfilgrastim (Neulasta) became available in New Zealand in May 2013. Individual physicians may choose to prescribe G-CSF prophylaxis for any patient they believe fits the funding criteria. We therefore reviewed current clinical practice and outcomes in this patient population.
    
    Method:
    A retrospective audit of patients 18 years and over with a histologically confirmed diagnosis of extensive stage small cell lung cancer who were schedule to receive carboplatin with or without etoposide chemotherapy, from 1 January 2015 to 31 December 2015 was undertaken. Primary end point was rate of febrile neutropenia (FN) with secondary end points of G-CSF use, patient related risk factors for FN and dose reductions / delays.
    
    Result:
    32 patients met the inclusion criteria, 29 of these received chemotherapy. The rate of FN in the entire population was 14% (4 episodes in 29 patients). One patient had 2 episodes of FN. The rate of FN in patients not receiving primary G-CSF was 13% (3 episodes in 23 patients). Six patients were administered G-CSF in the primary setting (20%, 6/29). One patient treated with primary G-CSF had FN (20%, 1/6). Two patients received G-CSF in the secondary setting. Risk factors for FN were commonly seen, including age >65 years (63%) chronic obstructive respiratory disease (41%) and multiple co-morbid conditions (22%). Treatment delays were experienced by 14 patients (48%) at some stage throughout their chemotherapy primarily due to haematological toxicity. Dose reductions occurred in 17 patients (58%).
    
    Conclusion:
    This retrospective audit confirms an overall rate of FN of 14%, in keeping with published data of moderate risk of neutropenia with carboplatin etoposide chemotherapy. In this retrospective study, primary G-CSF did not decrease this risk, but numbers are small. This population of patients commonly have risk factors for FN and many patients experience treatment delays. Given this and the importance of dose intensity in the treatment of small cell lung cancer, consideration for primary G-CSF support is warranted.