Multivariable regression analysis of febrile neutropenia occurrence in early breast cancer patients receiving chemotherapy assessing patient-related, chemotherapy-related and genetic risk factors

Aim: To screen clinical and genetic risk factors and examine their combined effect on docetaxel, epirubicin and cyclophosphamide (TEC) regimen-induced liver injury (TEC-ILI). Patients & methods: We enrolled 396 breast cancer patients, and TEC-ILI-associated factors were screened by logistic regression analyses. Results: SOD2 rs4880 and ABCG2 rs2231142 polymorphisms correlated with an increased risk of TEC-ILI. Multivariate analysis incorporating clinical and genetic factors revealed that ABCC1 rs246221 (CC) and SOD2 rs4880 (AG/GG) increased the risk of TEC-ILI. Patients with at least two risk factors among nonalcoholic fatty liver disease, high low-density lipoproteinemia levels and the rs246221 or rs4880 adverse genotypes exhibited a significantly increased risk of developing TEC-ILI. Conclusion: The combination of clinical and genetic risk factors had higher predictive value for TEC-ILI than the interclinical risk factors alone.

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Clinical and genetic risk factors for Fulvestrant treatment in post-menopause ER-positive advanced breast cancer patients

Journal of Translational Medicine ◽

10.1186/s12967-018-1734-x ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 9

Author(s):

Jingyu Liu ◽

Jing Li ◽

Hui Wang ◽

Yikai Wang ◽

Qiongzhi He ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Advanced Breast Cancer ◽

Cancer Patients ◽

Genetic Risk ◽

Genetic Risk Factors ◽

Advanced Breast ◽

Breast Cancer Patients ◽

Er Positive ◽

Post Menopause

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Older age limits the use of adjuvant chemotherapy according to all negative risk factors in early breast cancer patients

Journal of Clinical Oncology ◽

10.1200/jco.2004.22.14_suppl.8159 ◽

2004 ◽

Vol 22 (14_suppl) ◽

pp. 8159-8159

Author(s):

U. Basso ◽

A. Brunello ◽

C. Pogliani ◽

F. Lumachi ◽

L. M. Pasetto ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Early Breast Cancer ◽

Older Age ◽

Breast Cancer Patients ◽

Age Limits

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The impact of patient-related factors on the occurrence of febrile neutropenia in breast cancer patients receiving (neo-)adjuvant chemotherapy with 5-fluorouracil, epirubicin, and cyclofosfamide (FEC) x6 or FEC x3 followed by docetaxel (D) x3.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1078 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1078-1078

Author(s):

Christof Vulsteke ◽

Alena Pfeil ◽

Barbara Brouwers ◽

Matthias Schwenkglenks ◽

Robert Paridaens ◽

...

Keyword(s):

Breast Cancer ◽

Logistic Regression ◽

Regression Analysis ◽

Febrile Neutropenia ◽

Serum Creatinine ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Related Factors ◽

The Impact

1078 Background: Recently we described the impact of genetic variability on severe toxicity in breast cancer patients receiving (neo-) adjuvant FEC chemotherapy (Annals of Oncology 2013, In Press). We now further assessed the impact of a wide range of patient-related factors on FEC toxicity in routine clinical setting. Methods: Patients with early breast cancer receiving (neo-)adjuvant 6 cycles FEC or sequential 3 cycles of FEC and 3 cycles D were retrospectively evaluated through electronic chart review for febrile neutropenia (primary endpoint; CTC 3.0). Age at diagnosis, body mass index, body surface area, number of cycles received, germline genetic polymorphisms, and baseline biochemical variables (white blood cell count, absolute neutrophil count, platelets, aspartate aminotransferase, alanine aminotransferase, total bilirubin and creatinine) were available for most patients (missing data <10%). All patients had follow up for progression free survival (PFS) and overall survival (OS). Multivariate logistic regression analysis was performed including univariate associates of outcome with a p-value <0.25. Results: We identified 1,031 patients treated between 2000-2010 with 6x FEC (n=488) or 3x FEC followed by 3x D (n=543). 174 (16.9%) patients developed febrile neutropenia during FEC. After logistic regression analysis febrile neutropenia was found to be significantly associated with carriers of the rs45511401 variant T-allele in the MRP1 gene found in 12% of patients (p= 0.03, OR1.99, CI 1.07-3.71) and with increasing serum creatinine values (p=0.05 OR 4.58/CI 0.99-20.98); all other investigated patient-related parameters were not retained by the model. At a mean follow up of 5.2 years, the occurrence of febrile neutropenia was not correlated with PFS and OS. Conclusions: In this study, only the baseline level of serum creatinine and germline genetic polymorphisms in the MRP-1 gene were predictive for the occurrence of febrile neutropenia in patients receiving FEC chemotherapy. The occurrence of febrile neutropenia did not seem to impact on outcome.

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Risk Factors for Arm Lymphedema in a Cohort of Breast Cancer Patients Followed up for 10 Years

Breast Care ◽

10.1159/000442489 ◽

2015 ◽

Vol 11 (1) ◽

pp. 45-50 ◽

Cited By ~ 19

Author(s):

René Aloisio da Costa Vieira ◽

Allini Mafra da Costa ◽

Josue Lopes de Souza ◽

Rafael Richieri Coelho ◽

Cleyton Zanardo de Oliveira ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Regression Analysis ◽

Lymph Nodes ◽

Cancer Patients ◽

Multivariate Regression ◽

Axillary Dissection ◽

Breast Cancer Patients ◽

Arm Lymphedema

Background: The etiology of lymphedema is multifactorial, and definition criteria of lymphedema, its limitation, and follow-up must be considered in studies related to risk factors. The aim of this study is to evaluate risk factors related to arm lymphedema in a cohort study with a long follow-up. Patients and Methods: The study was performed in 622 breast cancer patients. The main endpoint reported was the presence of clinical lymphedema reported in medical records. Univariate and multivariate regression analyses were performed to identify factors related to lymphedema. Results: 66.4% of the patients were submitted to mastectomy, 88.4% to level III axillary lymphadenectomy, 34.9% to radiotherapy in the supraclavicular fossa, and 4.3% to axillary radiotherapy. The mean follow-up was 96.7 months. 45 patients (7.2%) developed lymphedema, of which 82.2% had developed lymphedema at 60 months. Univariate regression analysis showed that supraclavicular radiotherapy, adjuvant/palliative chemotherapy, ≥ 15 lymph nodes dissected, and axillary surgery increase the lymphedema rate by 1.87, 2.28, 2.03, and 6.17, respectively. Adjusted multivariate regression analysis showed that the combination of axillary dissection and number of lymph nodes dissected was the main factor related to lymphedema (p = 0.017). Conclusion: In the pre-sentinel era, axillary dissection and the number of lymph nodes resected are related to 10-year lymphedema.

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