Effectiveness and safety of the pre-prescription of garenoxacin in comparison to moxifloxacin for low-risk febrile neutropenia in breast cancer patients undergoing adjuvant and neoadjuvant chemotherapy

Support Care Cancer. 2019 Aug;27(8):2829-2836. doi: 10.1007/s00520-018-4589-z. Epub 2018 Dec 13.

Abstract

Purpose: The purpose of this study was to compare the efficacy of the pre-prescription of garenoxacin mesylate hydrate (GRNX) with that of moxifloxacin hydrochloride (MFLX) in the management of breast cancer patients with low-risk febrile neutropenia.

Methods: Data from female patients who had been instructed to take previously prescribed oral GRNX or MFLX for 3 days during adjuvant and neoadjuvant chemotherapy if their body temperature exceeded 38 °C were analyzed. This study compared the effectiveness between these fluoroquinolones using a propensity score matching analysis.

Results: The 330 patients received 1192 administrations of chemotherapy between May 2007 and April 2014 and 136 (41.2%) patients had a total of 212 (17.8%) febrile episodes. The frequencies of febrile episodes were 19.5% (113/579) and 16.2% (99/613) in the GRNX and MFLX groups, respectively. After propensity score matching, 384 episodes were matched in each group. Febrile events occurred in 80 and 56 cases in the GRNX and MFLX groups, respectively. Treatment success was identified in 80.0% (64/80) of cases in the GRNX group and 64.3% (36/56) of cases in the MFLX group (P = 0.0494). Additionally, the therapeutic use of granulocyte-colony stimulating factor was 6.3% (5/80) of cases in the GRNX group and 17.9% (10/56) of cases in the MFLX group (P = 0.0498). There were few differences in the frequency of adverse effects between the two groups.

Conclusions: These results indicate that the pre-prescription of GRNX may be a more effective option for the management of low-risk febrile neutropenia during adjuvant and neoadjuvant chemotherapy for breast cancer.

Keywords: Adjuvant chemotherapy; Breast cancer; Garenoxacin; Low-risk febrile neutropenia; Moxifloxacin; Pre-prescription.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Chemoprevention / adverse effects
  • Chemoprevention / methods
  • Chemotherapy, Adjuvant / adverse effects
  • Chemotherapy-Induced Febrile Neutropenia / etiology
  • Chemotherapy-Induced Febrile Neutropenia / prevention & control*
  • Female
  • Fluoroquinolones / adverse effects
  • Fluoroquinolones / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Moxifloxacin / adverse effects
  • Moxifloxacin / therapeutic use*
  • Neoadjuvant Therapy / adverse effects
  • Off-Label Use
  • Prior Authorization
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Fluoroquinolones
  • Moxifloxacin
  • garenoxacin