Services
Company
Legal and Governance
Publication Library / Publications
The rate of neutropenic sepsis (NS) and other haematological toxicities in patients with advanced non-small cell lung cancer (NSCLC) treated with docetaxel in the UK NHS: REVEAL-NS
Introduction
Following relapse after first-line chemotherapy, docetaxel is a standard of care for patients with advanced NSCLC, despite associated haematological toxicities, such as NS. This study assessed the docetaxel-related toxicities experienced by patients with NSCLC during routine UK clinical care.
Methods
REVEAL-NS: a retrospective observational study of 121 patients from seven NHS centres. Patient eligibility: diagnosis of locally advanced/metastatic NSCLC; single-agent docetaxel initiated following relapse after (or intolerance to) ≥1 line of chemotherapy; age ≥18 years; docetaxel initiated ≤6 years, and stopped ≥30 days before data collection. Data collected from medical records included: demographics, clinical history, docetaxel treatment and haematological toxicity episodes, including NS. The three NS definitions used (‘ANC ≤0.5’, ‘ANC ≤1.0’ and ‘suspected’), are shown in Table 1.
Results
Median age at docetaxel initiation: 65 years (range:42–83); 70/121 patients (57.9%) were male and 24/121 (19.8%) alive when data collected. Sixty-three patients (52.1%, [CI: 42.8–61.2%]) experienced ≥1 haematological toxicity episode. Anaemia was the most frequently-recorded episode (38/80, 47.5%), then NS (all definitions) (22/80, 27.5%), and neutropenia without sepsis (20/80, 25.0%). Proportions of patients experiencing ≥1 NS episode: ANC ≤0.5: 10/121 (8.3%, [CI: 4.0–14.7%]); ANC ≤1.0: 11/121 (9.1%, [CI: 4.6– 15.7%]); suspected: 21/121 (17.4%, [CI: 11.1–25.3%]), (not mutually exclusive).
Conclusions
The observed NS rate for ANC ≤0.5 was higher than previously reported in clinical trials (5.95%) [1], and was similar for ANC ≤1.0, a threshold which may better reflect clinical practice. This, and the higher rate of suspected NS observed (requiring clinical management as NS, until confirmed diagnosis), indicates that docetaxel-related NS has a considerable clinical impact on patients with NSCLC, and poses a greater burden on NHS resources than previously described [1].
Authors
T Talbot, A Dangoor, R Shah, J Naik, D Talbot, J F Lester, R Cipelli, M Hodgson, A Patel, M Summerhayes, T Newsom-Davis
Journal
Lung Cancer
Therapeutic Area
Oncology
Center of Excellence
Real-world Evidence & Data Analytics
Year
2017
Read full article