Docetaxel plus ramucirumab with primary prophylactic pegylated-granulocyte-colony stimulating factor for pretreated non-small cell lung cancer
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Akito Hata1, Daijiro Harada3, Chiyuki Okuda1, Reiko Kaji1, Yoshio Masuda2, Yoshika Takechi4, Toshiyuki Kozuki3, Naoyuki Nogami3 and Nobuyuki Katakami1
1Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
2Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
3Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
4Department of Pharmacy, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
Akito Hata, email: [email protected]
Keywords: docetaxel; ramucirumab; febrile neutropenia; pegylated-granulocyte-colony stimulating factor
Received: March 22, 2018 Accepted: May 21, 2018 Published: June 12, 2018
Purpose: The aim of our study was to evaluate the efficacy and safety of docetaxel plus ramucirumab with primary prophylactic pegylated (PEG)-granulocyte-colony stimulating factor (G-CSF) for pretreated non-small cell lung cancer (NSCLC).
Results: Sixty-one pretreated NSCLC patients underwent docetaxel plus ramucirumab. Primary prophylactic PEG-G-CSF was performed in 52 (85%) patients (prophylactic group). No febrile neutropenia (FN) (0%) was confirmed in 52 prophylactic group patients, whereas FN was observed in 3 (33%) of 9 non-prophylactic group patients. Among prophylactic group, median lines of prior therapy was 2 (range, 1–9). Median cycles of docetaxel plus ramucirumab was 3 (range, 1–25) (9 and 3 cases moved to ramucirumab and docetaxel monotherapies, respectively). Response rate and disease control rate were 30.8% and 73.1%, respectively. Median progression-free survival was 4.5 (95% confidence interval [CI], 3.0–6.6) months. Median overall survival was 11.4 (95% CI, 8.0–13.9) months. Six (11.5%) patients had grade 3/4 neutropenia. Observed grade 3 (incidence ≥10%) adverse event (AE) was oral mucositis (13.5%). There were no grade 4/5 non-hematological AEs.
Conclusions: Our study demonstrated the efficacy and safety of docetaxel plus ramucirumab with PEG-G-CSF in clinical practice. Primary prophylactic PEG-G-CSF could markedly reduce incidence of FN.
Methods: We retrospectively reviewed medical records of pretreated NSCLC cases who had received docetaxel plus ramucirumab in our departments.
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