TY - JOUR
T1 - Cefepime monotherapy for febrile neutropenia in patients with lung cancer
AU - Saito, Hiroshi
AU - Takahashi, Kosuke
AU - Okuno, Motoyasu
AU - Saka, Hideo
AU - Imaizumi, Kazuyoshi
AU - Hasegawa, Yoshinori
AU - Tanikawa, Yoshimasa
AU - Yamamoto, Masashi
AU - Taniguchi, Hiroyuki
AU - Shindoh, Joe
AU - Suzuki, Ryujiro
AU - Shimokata, Kaoru
PY - 2014/6
Y1 - 2014/6
N2 - We assessed the efficacy and safety of cefepime monotherapy (1 g intravenously every 8 h) for febrile neutropenia in patients with lung cancer in a multi-institutional phase II study. Patients treated with chemotherapy with or without radiotherapy for lung cancer were eligible for this study. Other eligibility criteria included fever (temperature of ≥38.0 °C) and an absolute neutrophil count of <500/mm3 or <1000/mm3 with an expected decline to <500/mm3 within the next 48 h. Risk assessment was performed using the Multinational Association of Supportive Care in Cancer risk-index score. Cefepime 1 g was given intravenously every 8 h. The primary endpoint was the response rate at the end of cefepime therapy. Co-administration of granulocyte-colony-stimulating factor was permitted. Of 54 patients enrolled, 39 were classified in the low-risk group and 15 in the high-risk group. Overall response rate was 78% (95% CI: 64.4-88.0%). The response rates were 85% (95% CI: 69.5-94.1%) in the low-risk group and 60% (95% CI: 32.3-83.7%) in the high-risk group, respectively. One patient died from septic shock due to Enterobacter cloacae bacteremia. There was no significant adverse event. Cefepime 1 g intravenously every 8 h appears to be effective for febrile neutropenia in patients with lung cancer, especially in those with low-risk febrile neutropenia, and is well tolerated.
AB - We assessed the efficacy and safety of cefepime monotherapy (1 g intravenously every 8 h) for febrile neutropenia in patients with lung cancer in a multi-institutional phase II study. Patients treated with chemotherapy with or without radiotherapy for lung cancer were eligible for this study. Other eligibility criteria included fever (temperature of ≥38.0 °C) and an absolute neutrophil count of <500/mm3 or <1000/mm3 with an expected decline to <500/mm3 within the next 48 h. Risk assessment was performed using the Multinational Association of Supportive Care in Cancer risk-index score. Cefepime 1 g was given intravenously every 8 h. The primary endpoint was the response rate at the end of cefepime therapy. Co-administration of granulocyte-colony-stimulating factor was permitted. Of 54 patients enrolled, 39 were classified in the low-risk group and 15 in the high-risk group. Overall response rate was 78% (95% CI: 64.4-88.0%). The response rates were 85% (95% CI: 69.5-94.1%) in the low-risk group and 60% (95% CI: 32.3-83.7%) in the high-risk group, respectively. One patient died from septic shock due to Enterobacter cloacae bacteremia. There was no significant adverse event. Cefepime 1 g intravenously every 8 h appears to be effective for febrile neutropenia in patients with lung cancer, especially in those with low-risk febrile neutropenia, and is well tolerated.
UR - http://www.scopus.com/inward/record.url?scp=84903724716&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903724716&partnerID=8YFLogxK
U2 - 10.1016/j.jiac.2014.02.002
DO - 10.1016/j.jiac.2014.02.002
M3 - Article
C2 - 24679653
AN - SCOPUS:84903724716
SN - 1341-321X
VL - 20
SP - 365
EP - 369
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 6
ER -
