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Through the use of aggressive supportive care, more patients may be able to receive their target doses and frequencies of therapy (42nd annual meeting of the American Society of Hematology). Continued administration of optimal doses of treatment is a crucial element in achieving superior responses for breast cancer patients.

Breast cancer is a common malignancy occurring in women in the United States, with almost 200,000 new cases diagnosed each year. A major component of treatment for a large majority of breast cancer patients includes chemotherapy. However, patients often experience severe side effects caused by chemotherapy and are unable to tolerate optimal doses and/or frequencies of treatment. Previous studies have shown that a reduction in target doses and/or frequencies of chemotherapy results in sub-optimal outcomes for these patients. In order to achieve optimal outcomes for these patients, research efforts have been ongoing in an attempt to decrease side effects associated with chemotherapy so patients can tolerate optimal treatment regimens.

A serious and common side effect associated with chemotherapy is an acute reduction of immune cells (neutropenia) in the body. Neutropenia leaves patients very susceptible to infections. Even slight infections can become life-threatening for a patient with neutropenia. If a patient experiences severe neutropenia, chemotherapy doses and/or frequencies are typically reduced so that the body can begin to restore immune cell levels.

Data from over 20,000 breast cancer patients treated from 1997 through 2000 was recently analyzed. This data revealed that only 37% of breast cancer patients received their target dose and frequency of chemotherapy during their treatment. The majority of dose reductions occurred in response to neutropenia.

A recent clinical trial was conducted utilizing aggressive supportive care against neutropenia in breast cancer patients with an agent called Neupogen®.

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Neupogen® is an injectable substance that stimulates the body to produce immune cells. The intent of this trial was to determine if the use of Neupogen® could ultimately allow patients to receive their intended chemotherapy treatment by maintaining elevated immune cell levels. Patients either received Neupogen® daily or in a slower release form (pegylated) that is effective if administered less frequently.

Patients receiving both forms of Neupogen® were able to receive over 90% of their chemotherapy at the scheduled time and over 85% of their full doses. Patients receiving the pegylated form of Neupogen® only required one dose per cycle of chemotherapy, allowing easier compliance than the regimen consisting of daily injections of Neupogen®.

These results indicate that aggressive supportive care with the use of Neupogen® may allow patients to receive their target chemotherapy treatment. This is important as it would improve a patient’s chances of achieving optimal long-term outcomes. Patients with breast cancer who require chemotherapy may wish to speak with their physician about the risks and benefits of receiving pegylated Neupogen® in order to maintain an optimal treatment regimen. (42, San Francisco, CA, 2000)

nd annual meeting of the American Society of Hematology

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