Less myelotoxicity in obese patients with weekly paclitaxel in localized breast cáncer

• Autores: Raúl Diez Fernández, Santos Enrech Francés, Laura López Esteban, T. Molina García
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 20, Nº. 5, 2018, págs. 257-262
• Idioma: inglés
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• Resumen

  • Introduction: AC protocol (doxorubicin, cyclophosphamide) followed by weekly paclitaxel is a standard adjuvant treatment for localized breast cancer patients. A retrospective study (Griggs, 2005) proved that obesity was independently associated with a lower likelihood of developing febrile neutropenia, even among those patients given full weight-based doses during AC protocol treatment. We aim to evaluate the risk of presenting clinically significant (CTCAE grade two or higher) neutropenia in obese patients with operable breast cancer during weekly paclitaxel treatment. Method: We performed a retrospective cohort study of women with localized breast cancer who had received adjuvant weekly paclitaxel. Patients were classified into two groups, depending on whether they were obese (BMI ≥30) or not. The main outcome was the onset of grade two or higher neutropenia in the blood test before each course of chemotherapy. Results: 192 patients were included in the analysis. Obese patients (24.5%) had a significantly lower risk of presenting neutropenia of any grade when compared to non-obese patients (19.1% vs. 38.6%; OR 0.38 95% CI: 0.17-0.84). The rate of grade two or higher neutropenia was also significantly less in obese patients (8.5% vs. 24.8%; OR 0.28 95% CI: 0.09-0.84). No obese patient had severe neutropenia against 5.5% of non-obese patients. None of the patients developed grade 4 neutropenia. Less patients in the obese group required growth factor support (2.1% vs. 3.4%; OR 0.61 95% CI: 0.07-5.35). Conclusions: Obese patients with localized breast cancer have a lower risk of presenting neutropenia during treatment with weekly paclitaxel than patients without obesity