“This study is already changing practice around the world,” said Dr. Mark Clemons.”A new study published in Annals of Oncology shows that a drug commonly used to prevent infections in breast cancer patients can safely be given less often, meaning fewer hospital visits, fewer side effects and reduced treatment costs.
The study focused on a drug called filgrastim, which boosts the production of infection-fighting white blood cells. People with early stage breast cancer often receive daily injections of the drug at the start of every cycle of chemotherapy, but there has been debate about how many injections are best.
After reviewing all the evidence and surveying doctors and patients, researchers at The Ottawa Hospital and the University of Ottawa realized that there was no clear answer. So they launched a clinical trial to find out, enrolling 466 patients from seven Canadian cancer centres.
They found that five doses of filgrastim are just as good as 7-10 doses in terms of preventing infections. And when they looked at treatment-related hospitalizations, they found that five doses are better: patients who received five doses had a 3.3 percent chance of hospitalization for side-effects compared to 10.9 percent for people who had 7-10 doses, a difference of more than three-fold.
“This study is already changing practice around the world,” said lead author Dr. Mark Clemons, scientist and oncologist at The Ottawa Hospital and professor at the University of Ottawa. “It is making our patients healthier and giving them more time with loved ones by reducing unnecessary hospital visits. It is also saving our health-care system millions of dollars every year.”
“By thinking differently and using innovative approaches, we are efficiently answering some of the most important questions for patients and for our health care system,” said Dr. Dean Fergusson.This trial is part of The Ottawa Hospital’s REthinking Clinical Trials (REaCT) program, launched by Dr. Clemons in 2014, together with Dr. Dean Fergusson and others.
Unlike most cancer clinical trials, which are focused on evaluating experimental treatments in a very narrow patient population, REaCT trials compare standard approved treatments in a real-world setting with a broad range of patients. REaCT trials also engage patients in setting research priorities and use innovative approaches for enrollment. With more than 2,700 patients participating in 17 trials in 15 centres, REaCT is now the largest pragmatic cancer clinical trials program in Canada.
REaCT builds on innovative research approaches and tools developed by Dr. Dean Fergusson and others as part of The Ottawa Hospital’s Ottawa Methods Centre.
“By thinking differently and using innovative approaches, we are efficiently answering some of the most important questions for patients and for our health care system,” said Dr. Dean Fergusson, senior scientist and Director of The Ottawa Hospital’s Clinical Epidemiology Program and professor at the University of Ottawa. “The Ottawa Hospital is a leader in this kind of innovative research and our patients are among the first to benefit.”
This kind of research is possible because of generous support from the community, through The Ottawa Hospital Foundation. Additional support was provided by the Canadian Institutes of Health Research (Strategy for Patient Oriented Research) and Cancer Care Ontario.
Full reference: A multicentre, randomised trial comparing schedules of G-CSF (filgrastim) administration for primary prophylaxis of chemotherapy-induced febrile neutropenia in early stage breast cancer. Clemons M, Fergusson D, Simos D, Mates M, Robinson A, Califaretti N, Zibdawi L, Bahl M, Raphael J, Ibrahim MFK, Fernandes R, Pitre L, Aseyev O, Stober C, Vandermeer L, Saunders D, Hutton B, Mallick R, Pond GR, Awan A, Hilton J. Ann Oncol. 2020 Jul;31(7):951-957. doi: 10.1016/j.annonc.2020.04.005.
The Ottawa Hospital is one of Canada’s top learning and research hospitals, where excellent care is inspired by research and driven by compassion. As the third-largest employer in Ottawa, our support staff, researchers, nurses, physicians, and volunteers never stop seeking solutions to the most complex health-care challenges. Our multi-campus hospital, affiliated with the University of Ottawa, attracts some of the most influential scientific minds from around the world. Backed by generous support from the community, we are committed to providing the world-class, compassionate care we would want for our loved ones. www.ohri.ca
Media contact
Jenn Ganton
jganton@ohri.ca
613-614-5253
