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Leukocyte nadir as ...
Leukocyte nadir as a predictive factor for efficacy of adjuvant chemotherapy in breast cancer. Results from the prospective trial SBG 2000-1
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- Poikonen-Saksela, Paula (author)
- Helsinki Univ Hosp, Comprehens Canc Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
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- Lindman, Henrik (author)
- Uppsala universitet,Experimentell och klinisk onkologi
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- Sverrisdottir, Asgerdur (author)
- Sodersjukhuset, Dept Oncol, Stocholm, Sweden.;Landspitali Univ Hosp, Dept Oncol, Reykjavik, Iceland.
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- Edlund, Per (author)
- Gävle Cent Hosp, Dept Oncol, Gävle, Sweden.
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- Villman, Kenneth (author)
- Örebro Univ Hosp, Dept Oncol, Örebro, Sweden.
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- Nittby, Lena Tennvall (author)
- Skane Univ Hosp, Dept Oncol, Malmö, Sweden.
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- Cold, Soren (author)
- Odense Univ Hosp, Dept Oncol, Odense, Denmark.
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- Bechmann, Troels (author)
- Hosp South West Jutland, Dept Oncol, Esbjerg, Denmark.;Vejle Hosp, Dept Oncol, Vejle, Denmark.
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- Stenbygaard, Lars (author)
- Aalborg Univ Hosp, Dept Oncol, Aalborg, Denmark.
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- Ejlertsen, Bent (author)
- Rigshosp, Dept Oncol, Copenhagen, Denmark.
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- Andersson, Michael (author)
- Rigshosp, Dept Oncol, Copenhagen, Denmark.
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- Blomqvist, Carl (author)
- Helsinki Univ Hosp, Comprehens Canc Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.;Örebro Univ Hosp, Dept Oncol, Örebro, Sweden.
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- Bergh, Jonas (author)
- Karolinska Institutet
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- Ahlgren, Johan (author)
- Gävle Cent Hosp, Dept Oncol, Gävle, Sweden.
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Helsinki Univ Hosp, Comprehens Canc Ctr, Helsinki, Finland;Univ Helsinki, Helsinki, Finland. Experimentell och klinisk onkologi (creator_code:org_t)
- Informa UK Limited, 2020
- 2020
- English.
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In: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 59:7, s. 825-832
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- 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/m(2)). 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- NCT03888677
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Poikonen-Saksela ...
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Lindman, Henrik
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Sverrisdottir, A ...
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Edlund, Per
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Villman, Kenneth
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Nittby, Lena Ten ...
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Cold, Soren
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Bechmann, Troels
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Stenbygaard, Lar ...
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Ejlertsen, Bent
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Andersson, Micha ...
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Blomqvist, Carl
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Bergh, Jonas
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Ahlgren, Johan
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Acta Oncologica
- By the university
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Uppsala University
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Karolinska Institutet