Incidence and predictors of febrile neutropenia in patients with metastatic castrate- resistant prostate cancer receiving docetaxel

Abstract

Abstract Purpose The incidence of febrile neutropenia (FN) in adults with castrate-resistant metastatic prostate cancer (mCRPC) receiving docetaxel in real-world settings since the expanded role of hormonal treatments has not been well studied. The study objective is to determine the incidence of FN and neutropenia among adults with mCRPC receiving docetaxel. Secondary objectives are to quantify outcomes of patients who develop FN and to identify predictors for FN in this population. Methods A single-centre retrospective cohort study was conducted which included adults with mCRPC receiving docetaxel at the Ottawa Hospital over a 5-year period. Charts were reviewed to collect clinical data to determine the incidence of FN. A multiple logistic regression was used to identify predictors of FN. Results In patients receiving docetaxel for mCRPC, the incidence of FN and neutropenia was 34/137 (25%) and 45/137 (33%), respectively. Among 34 patients who developed FN, 94% required hospitalization for FN for a mean of 5 days (+/- 2.8) and 6% died. Following FN, 53% required at least 1 treatment delay, 71% had at least 1 dose reduction and 18% received secondary prophylaxis with WBC Growth-Factors. Age category [OR 2.025, 95% CI 1.13–3.627] and presence of multiple comorbidities [OR 1.466, 95% CI 1.01–2.258] increased the risk of FN. Conclusion The incidence of FN and neutropenia in the clinical setting in patients receiving docetaxel for mCRPC is higher than previously reported and high enough to consider primary prophylaxis in high-risk groups. Age and multiple comorbidities were identified as risk factors.