{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T11:38:38Z","timestamp":1791459518096,"version":"4.3.4"},"reference-count":23,"publisher":"Harborside Press, LLC","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Prophylactic growth-factor therapy with granulocyte colony-stimulating factor (G-CSF) reduces the risk of febrile neutropenia (FN) in patients with breast cancer initiating myelosuppressive chemotherapy. However, little is known about the protective benefit early in the chemotherapy cycle. <jats:bold>Methods:<\/jats:bold> To assess the relationship between G-CSF prophylaxis and incidence of FN\/infection in week 1 versus beyond week 1 of the first chemotherapy cycle, a retrospective study was conducted using Medicare claims from 2005 through 2020 among patients with breast cancer initiating high-risk chemotherapy. Two cohorts were compared based on G-CSF prophylaxis within 3 days following chemotherapy initiation. The primary outcome was FN or infection, defined as hospitalization with neutropenia, fever, or infection diagnosis. Secondary outcomes were a stricter definition of FN and infection-related hospitalization. Unadjusted and regression-adjusted proportions of patients experiencing each outcome during week 1 versus beyond week 1 of the first chemotherapy cycle were compared. <jats:bold>Results:<\/jats:bold> Of 78,810 patients meeting all inclusion criteria (&gt;98% female; mean age, 69 years), 79% initiated TC (docetaxel\/cyclophosphamide), 14% TCH (docetaxel\/carboplatin\/trastuzumab), and 7% TAC (docetaxel\/doxorubicin\/cyclophosphamide). Among patients receiving G-CSF (74%), incidence of first-cycle FN\/infection was lower compared with patients not receiving G-CSF (overall, 6% vs 13%; TAC, 12% vs 19%; TC, 6% vs 12%; TCH, 5% vs 15%). However, patients who received G-CSF were generally more likely to experience FN\/infection in week 1 (adjusted odds ratio [aOR], 1.24 for all; 1.73 for TAC; 1.35 for TC; and 0.76 for TCH). Results were similar for strictly defined FN (overall aOR, 1.29 for week 1 and 0.12 for beyond week 1) and infection-related hospitalization (overall aOR, 1.33 for week 1 and 0.27 for beyond week 1). <jats:bold>Conclusions:<\/jats:bold> Overall, the rates of chemotherapy-related FN and infection in week 1 of the first chemotherapy cycle are similar for patients receiving and not receiving G-CSF, suggesting continued risk in week 1 despite prophylactic G-CSF.<\/jats:p>","DOI":"10.6004\/jnccn.2023.7044","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T19:36:06Z","timestamp":1694028966000},"page":"945-950.e16","source":"Crossref","is-referenced-by-count":3,"title":["Real-World Impact of Prophylactic Growth Factor Use on Timing of Febrile Neutropenia and Infection After High-Risk Chemotherapy"],"prefix":"10.6004","volume":"21","author":[{"given":"Douglas W.","family":"Blayney","sequence":"first","affiliation":[{"name":"Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Kuderer","sequence":"additional","affiliation":[{"name":"Advanced Cancer Research Group, Kirkland, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice Kate","family":"Cummings Joyner","sequence":"additional","affiliation":[{"name":"Medicus Economics, LLC, Milton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Medicus Economics, LLC, Milton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Nunag","sequence":"additional","affiliation":[{"name":"Medicus Economics, LLC, Milton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Wells","sequence":"additional","affiliation":[{"name":"BeyondSpring Pharmaceuticals, Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Huang","sequence":"additional","affiliation":[{"name":"BeyondSpring Pharmaceuticals, Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Monhanlal","sequence":"additional","affiliation":[{"name":"BeyondSpring Pharmaceuticals, Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary H.","family":"Lyman","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington"},{"name":"Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington"},{"name":"Division of Oncology, Department of Medicine, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"JAMA Oncol","first-page":"1751","article-title":"Febrile neutropenia","volume":"3","author":"Patel K","year":"2017","unstructured":"Patel K, West HJ. 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