Safety of Same-day Pegfilgrastim Administration in Metastatic Castration-resistant Prostate Cancer Treated With Cabazitaxel With or Without Carboplatin

• Type of Material: Article
• Authors: Mehmet Asim Bilen, Emory University; Diana H. Cauley, The University of Texas MD Anderson Cancer Center; Bradley J Atkinson, The University of Texas MD Anderson Cancer Center; Hsiang-Chun Chen, The University of Texas MD Anderson Cancer Center; Diana H. Kaya, The University of Texas MD Anderson Cancer Center; Xuemei Wang, The University of Texas MD Anderson Cancer Center; Raghu Vikram, The University of Texas MD Anderson Cancer Center; Shi-Ming Tu, The University of Texas MD Anderson Cancer Center; Paul G. Corn, The University of Texas MD Anderson Cancer Center; Jeri Kim, The University of Texas MD Anderson Cancer Center
• Language: English
• Date: 2017-06-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Inc.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.clgc.2016.12.003
• Title of Journal or Parent Work: Clinical Genitourinary Cancer
• ISSN: 1558-7673
• Volume: 15
• Issue: 3
• Start Page: E429
• End Page: E435
• Grant/Funding Information: This work was supported in part by the National Institutes of Health through MD Anderson Cancer Center’s Support Grant CA016672 (Clinical Trials Support Resource).
• Keywords: PHASE-II; Anti-VEGF therapy; BREAST-CANCER; CLINICAL-PRACTICE GUIDELINE; Toxicity; Oncology; Urology & Nephrology; HEMORRHAGIC CYSTITIS; Therapy trends; CHEMOTHERAPY; Science & Technology; ADJUVANT; RECOMMENDATIONS; Kidney cancer; Life Sciences & Biomedicine; GROWTH-FACTORS; Cytokine; UPDATE; TRIAL
• Research Categories: Health Sciences, Radiology; Biology, Biostatistics

Abstract

Although myeloid growth factors are commonly used to treat metastatic castration-resistant prostate cancer, the optimal timing of administration has not been well studied. We demonstrate that same-day pegfilgrastim administration after cabazitaxel treatment with or without carboplatin in patients with metastatic castration-resistant prostate cancer is feasible. Furthermore, we observed that the rate of urinary tract inflammation was higher than that reported anecdotally. Introduction Although myeloid growth factors are commonly used to treat metastatic castration-resistant prostate cancer (mCRPC), the optimal timing of administration has not been well studied. We assessed the effects of same-day pegfilgrastim, a neutrophil stimulator, after cabazitaxel treatment with or without carboplatin in patients with mCRPC. We also evaluated the frequency of urinary tract inflammation during treatment. Patients and Methods Between September 2010 and September 2014, 151 consecutive patients with mCRPC underwent cabazitaxel treatment with or without the addition of carboplatin at a single institution. We assessed absolute neutrophil count recovery, incidence of neutropenia, neutropenic fever, antibiotic usage, treatment delays or discontinuation, dose reduction, and hospitalization with pegfilgrastim administration. Radiologists blinded to therapy reviewed computed tomography scans to detect urinary tract inflammation. Results The median patient age was 69 years (range, 41-88 years); 78% of patients were white, and 54% had a Gleason score ≥ 9. Median overall survival was 9 months (95% confidence interval, 8-11 months). One patient (< 1%) had neutropenia; 38 patients (25%) had infection. During cycle 1, a significantly higher proportion of patients receiving pegfilgrastim after 24 hours developed infection than did those receiving pegfilgrastim the same day (26% vs. 6%; P = .01). Conclusion Same-day pegfilgrastim administration after cabazitaxel treatment with or without carboplatin in patients with mCRPC is feasible. The urinary tract inflammation rate (21%) was higher than that reported anecdotally. Results need to be prospectively validated.