PMID- 33281065
OWN - NLM
STAT- MEDLINE
DCOM- 20211203
LR  - 20211214
IS  - 1938-0674 (Electronic)
IS  - 1533-0028 (Linking)
VI  - 20
IP  - 2
DP  - 2021 Jun
TI  - Occurrence and Management of Thrombocytopenia in Metastatic Colorectal Cancer 
      Patients Receiving Chemotherapy: Secondary Analysis of Data From Prospective 
      Clinical Trials.
PG  - 170-176
LID - S1533-0028(20)30142-0 [pii]
LID - 10.1016/j.clcc.2020.10.004 [doi]
AB  - INTRODUCTION: Chemotherapy-induced thrombocytopenia (CIT) contributes to 
      treatment dose delay and/or modification, often resulting in poorer survival and 
      disease progression. We explored the incidence and clinical consequences of CIT 
      among metastatic colorectal cancer (mCRC) patients. MATERIALS AND METHODS: Data 
      from two prospective randomized phase 3 trials of mCRC patients receiving either 
      first-line FOLFOX4 (fluorouracil, leucovorin, oxaliplatin) or second-line FOLFIRI 
      (fluorouracil, leucovorin, irinotecan) were analyzed. Thrombocytopenia was 
      defined by platelet count < 100 x 10(9)/L (further categorized by grade) and by 
      recorded adverse events (AEs). Co-occurrence of anemia (hemoglobin < 12 g/dL) and 
      neutropenia (neutrophil count < 2 x 10(9)/L) and clinical consequences of CIT 
      were also evaluated. RESULTS: Among 1078 mCRC patients in the FOLFOX4 study, 
      cumulative incidence of CIT based on platelet count was 37% (grade 3, 2%; grade 
      4, 1%) during an average 8 months' follow-up. Neutropenia or anemia were absent 
      in 44% of CIT episodes; 62% of CIT AEs led to chemotherapy dose delay, change, 
      and/or discontinuation. Among 1067 mCRC patients in the FOLFIRI study, cumulative 
      incidence of CIT based on platelet count was 4% (grade 3, < 1%; grade 4, 0) 
      during an average 4 months' follow-up. Neutropenia or anemia were absent in 22% 
      of CIT episodes; 32% of CIT AEs led to chemotherapy dose delay, change, and/or 
      discontinuation. With both regimens, transfusions and hospitalizations after CIT 
      AEs were rare (< 3%). CONCLUSION: CIT was common among mCRC patients receiving 
      the FOLFOX4 regimen. The most frequent consequence of CIT was a delay in 
      chemotherapy, highlighting the unmet need in CIT management.
CI  - Copyright (c) 2020 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Kilpatrick, Karynsa
AU  - Kilpatrick K
AD  - Amgen Inc, Thousand Oaks, CA.
FAU - Shaw, Jaime L
AU  - Shaw JL
AD  - Amgen Inc, Thousand Oaks, CA. Electronic address: jshaw03@amgen.com.
FAU - Jaramillo, Renee
AU  - Jaramillo R
AD  - SimulStat Inc, Solana Beach, CA.
FAU - Toler, Andrew
AU  - Toler A
AD  - Amgen Inc, Thousand Oaks, CA.
FAU - Eisen, Melissa
AU  - Eisen M
AD  - Amgen Inc, Thousand Oaks, CA.
FAU - Sangare, Laura
AU  - Sangare L
AD  - SimulStat Inc, Solana Beach, CA.
FAU - Soff, Gerald A
AU  - Soff GA
AD  - Hematology Service, Memorial Sloan-Kettering Cancer Center, New York, NY.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201101
PL  - United States
TA  - Clin Colorectal Cancer
JT  - Clinical colorectal cancer
JID - 101120693
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Aged
MH  - Anemia/chemically induced
MH  - Antineoplastic Agents/administration & dosage/*adverse effects
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse 
      effects
MH  - Colorectal Neoplasms/*drug therapy/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic
MH  - Thrombocytopenia/*chemically induced/drug therapy
OTO - NOTNLM
OT  - CIT
OT  - Chemotherapy dose delay
OT  - FOLFIRI
OT  - FOLFOX4
OT  - mCRC
EDAT- 2020/12/08 06:00
MHDA- 2021/12/15 06:00
CRDT- 2020/12/07 05:28
PHST- 2020/08/18 00:00 [received]
PHST- 2020/10/07 00:00 [revised]
PHST- 2020/10/26 00:00 [accepted]
PHST- 2020/12/08 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2020/12/07 05:28 [entrez]
AID - S1533-0028(20)30142-0 [pii]
AID - 10.1016/j.clcc.2020.10.004 [doi]
PST - ppublish
SO  - Clin Colorectal Cancer. 2021 Jun;20(2):170-176. doi: 10.1016/j.clcc.2020.10.004. 
      Epub 2020 Nov 1.