Incidence, predictors, and outcomes of febrile neutropenia and neutropenia in patients with metastatic castrate-resistant prostate cancer receiving docetaxel

PurposeThe incidence of febrile neutropenia (FN) in adults with castrate-resistant metastatic prostate cancer (mCRPC) receiving docetaxel in real-world settings has not been well studied since the expanded role of hormonal treatments. The study objective was to determine the incidence of FN and neutropenia among adults with mCRPC receiving docetaxel. Secondary objectives were to quantify outcomes of patients who develop FN and to identify predictors for FN in this population.MethodsA single-center retrospective cohort study was conducted which included adults with mCRPC receiving docetaxel at the Ottawa Hospital over a 5-year period. Charts were reviewed to collect clinical data to determine the incidence of FN and neutropenia. A multiple logistic regression was used to identify predictors of FN.ResultsIn patients receiving docetaxel for mCRPC, the incidence of FN and neutropenia was 34/137 (25%) and 45/137 (33%), respectively. Among 34 patients who developed FN, 94% required hospitalization for FN for a mean of 5 days (+/- 2.8) and 6% died. Following FN, 53% required at least 1 treatment delay and 71% had at least 1 dose reduction. Age category (OR 2.025, 95% CI 1.13-3.627) and presence of multiple comorbidities (OR 1.466, 95% CI 1.01-2.258) increased the risk of FN.ConclusionThe incidence of FN and neutropenia in the clinical setting in patients receiving docetaxel for mCRPC is higher than previously reported and high enough to consider primary prophylaxis with granulocyte colony stimulating factors in high-risk groups. Age and multiple comorbidities were identified as risk factors.