Consider Febrile Neutropenia Risk When Administering Standard Treatment in Prostate Cancer

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Patients with castration-resistant prostate cancer currently receive docetaxel as the standard treatment therapy. It is well known, however, that treatment with docetaxel can induce adverse events like febrile neutropenia, which can be life-threatening or impair the quality of a patient’s life.

Researchers from the Department of Urology Graduate School of Medical Sciences at Kyushu University in Fukuoka, Japan, studies the potential adverse events associated with febrile neutropenia to clarify the risk factors in patients with castrate-resistant prostate cancer.

The research was based on the study of 37 Japanese patients with castration-resistant prostate cancer who were being treated with 70-75 mg/m2 docetaxel and 10 mg prednisone every 3 or 4 weeks between 2008 and 2012. All risk factors for febrile neutropenia and adverse events were analyzed, as was the prognostic significance of several clinicopathological factors. Blood-related adverse events grade 3 or higher included neutrocytopenia in 36 patients (97.3 %), leukopenia in 24 patients (64.9 %), lymphopenia in 10 patients (27.0 %), and febrile neutropenia in 4 patients (10.8 %).

Also observed were severe non-blood related adverse events, which included acute respiratory distress syndrome, colononic perforation, and interstitial pneumonia—all of which occurred in 1 patient each. Severe lymphopenia was positively associated with the incidence of febrile neutropenia.

The researchers determined that low lymphocyte count  and low serum albumin were possibly before treatment risk factors and that severe lymphopenia was a risk factor after treatment. The researchers concluded that lymphopenia and serum albumin after treatment should be factored in an effort to minimize the risk of febrile neutropenia when selecting docetaxel therapy for patients with prostate cancer.

Transperineal mapping prostate biopsy
Docetaxel can induce adverse events like febrile neutropenia in prostate cancer patients.
In this study, the authors clarified the AEs and risk factors associated with FN in clinical settings. Non-hematological AEs as well as substantial hematological AEs were recognized in the Japanese population treated with docetaxel chemotherapy against CRPC.

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