Resumen de Taxanes related hematological toxicity in patients with breast cancer: A systematic review of the past 20 years

Raúl Diez Fernández, Santos Enrech Francés, T. Molina García

• development of hematological toxicity, both patient-related and treatment-related were extracted. Hematological toxicity, grades 3 and 4, and febrile neutropenia data were also extracted. Results of the analysis were shown according treatment schedule. Hematological toxicity data reported from 17,264 patients of 44 clinical included in the analysis. The incidence of severe neutropenia is much with docetaxel than with paclitaxel, weekly administration is associated with less myelosuppression than every three weeks administration for both taxanes, and patients with advanced disease have greater chances of developing hematological toxicity, probably due to previous chemotherapy affecting the bone marrow. The risk of febrile neutropenia in all cases is always less than 20% in all settings and only when docetaxel is given every threes weeks alone or when it is administered together with a biological drug the incidence is above 10%. The incidence of grade 3 and 4 anaemia and thrombocytopenia was extremely low.

  Conclusions: According to this analysis, prophylactic support with growth factor is not recommended when paclitaxel is administered either alone or combined with a biological drug, regardless of the disease stage or the treatment schedule.In those patients receiving docetaxel alone every three weeks or when combined with a biological drug it may be considered. When docetaxel is given alone on a weekly schedule, the use of GCSF is not recommended