Leukocyte nadir as a predictive factor for efficacy of adjuvant chemotherapy in breast cancer. Results from the prospective trial SBG 2000-1
| Autor: | Asgerdur Sverrisdottir, Kenneth Villman, Johan Ahlgren, Henrik Lindman, Carl Blomqvist, Jonas Bergh, Paula Poikonen-Saksela, Per Edlund, Søren Cold, Martin Andersson, Lars Stenbygaard, Troels Bechmann, Bent Ejlertsen, Lena Tennvall Nittby |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Adolescent Adjuvant chemotherapy Breast Neoplasms Disease-Free Survival 030218 nuclear medicine & medical imaging 03 medical and health sciences NCT03888677 Leukocyte Count Young Adult 0302 clinical medicine Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Nadir Humans Radiology Nuclear Medicine and imaging Prospective Studies Cyclophosphamide Epirubicin Leukopenia business.industry Retrospective cohort study Hematology General Medicine Middle Aged medicine.disease humanities 3. Good health Predictive factor Survival Rate Treatment Outcome Prospective trial Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female Fluorouracil medicine.symptom business Febrile neutropenia |
| Zdroj: | Poikonen-Saksela, P, Lindman, H, Sverrisdottir, A, Edlund, P, Villman, K, Tennvall Nittby, L, Cold, S, Bechmann, T, Stenbygaard, L, Ejlertsen, B, Andersson, M, Blomqvist, C, Bergh, J & Ahlgren, J 2020, ' Leukocyte nadir as a predictive factor for efficacy of adjuvant chemotherapy in breast cancer. Results from the prospective trial SBG 2000-1 ', Acta Oncologica, vol. 59, no. 7, pp. 825-832 . https://doi.org/10.1080/0284186X.2020.1757149 Poikonen-Saksela, P, Lindman, H, Sverrisdottir, A, Edlund, P, Villman, K, Tennvall Nittby, L, Cold, S, Bechmann, T, Stenbygaard, L, Ejlertsen, B, Andersson, M, Blomqvist, C, Bergh, J & Ahlgren, J 2020, ' Leukocyte nadir as a predictive factor for efficacy of adjuvant chemotherapy in breast cancer. Results from the prospective trial SBG 2000–1 ', Acta Oncologica, vol. 59, no. 7, pp. 825-832 . https://doi.org/10.1080/0284186X.2020.1757149 |
| Popis: | Background: Retrospective studies have suggested that chemotherapy-induced leukopenia is associated with improved recurrence-free or overall survival. The SBG 2000–1 trial was designed to verify the favorable prognosis associated with chemotherapy-induced leukopenia in early breast cancer. Patients not experiencing chemotherapy-induced leukopenia were randomized into standard dosed or individually escalated chemotherapy doses based on the grade of leukopenia after a first standard dose. Patients and methods: 1452 women in Sweden and Denmark with operable node-positive or high-risk node-negative breast cancer aged 18–60 years were recruited to participate in this trial. Participants received a first FEC cycle at standard doses (600/60/600 mg/m2). Patients (n = 1052) with nadir leukopenia grade 0–2 after the first cycle were randomized between either 6 standard FEC or 6 tailored FEC courses with doses of epirubicin and cyclophosphamide escalated during courses 2 and 3 and thereafter aimed at achieving grade 3 leukopenia. Patients with nadir leukopenia grade 3–4 after the first course continued treatment with standard FEC. Results of the randomized comparison has been published previously. The present study focuses on chemotherapy-induced leukopenia as a covariable with outcome in randomized and non-randomized patients. The prognostic value of leukopenia after course 3, was studied in a Cox model adjusted for cumulative doses of epirubicin and cyclophosphamide. The association of chemotherapy-induced leukopenia with prognosis was a preplanned secondary endpoint for this trial. Results: The eight-year distant disease-free survival was 73%, 77%, 78% and 83% for patients with leucocyte nadir grade 0, 1, 2 and 3–4, respectively. Higher degree of leukopenia was highly significantly associated to improved distant disease-free survival (HR 0.84, 95% CI 0.74–0.96, p =.008) and overall survival (HR 0.87 (0.76–0.99, p =.032). Conclusion: This prospective study confirms that chemotherapy-induced leukopenia is a covariable with outcome in primary breast cancer, even after adjustment for chemotherapy doses. |
| Databáze: | OpenAIRE |
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