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Breast Cancer • Medical Oncology • Journal Club ft. NEJM publications • Breast Cancer, Metastatic
How do you address and mitigate neutropenia in patients with TNBC receiving sacituzumab govitecan in 3rd line or beyond?
Many of the patients on ASCENT trial were heavily pre-treated and require growth factors. With the day 1,8 treatment cycle, is there a way to minimize return trips to infusion center for growth factors?
Answer from: Medical Oncologist at Academic Institution
For those who develop neutropenia, I generally use neulasta after day 8, but I don't use it with cycle 1 in all comers, unless they are heavily pre-treated and already have a relatively low ANC prior to starting treatment.
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Answer from: Medical Oncologist at Community Practice
I find that some people do have significant neutropenia and others barely any at all. I have had great success with the use of growth factors in those patients who struggle with counts. Additionally, dose reductions can be employed with success as well.
Answer from: Medical Oncologist at Academic Institution
Neutropenia can usually be managed with dose-reduction and/or growth factor support. To minimize extra trips, the provider could consider dose-reduction. In subset analysis from ASCENT, the clinical outcomes were similar in patients who had dose-reduction vs not (Rugo et al, SABCS 2020).
Answer from: Medical Oncologist at Academic Institution
Recommend growth factors for 3 to 4 days weekly.
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Medical Oncologist at Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
3 to 4 days daily per week growth factors not user...
3 to 4 days daily per week growth factors not user...