REthinking Clinical Trials

REaCT-G and G2

REaCT-G and G2

Duration of G-CSF treatment (5 days vs 7/10 days) during chemotherapy

Principal Investigator(s): Dr. Mark Clemons NCT02428114
In patients with early-stage breast cancer, chemotherapy has substantially improved survival rates. Improvements in outcomes, however, are compromised by the considerable toxicities associated with chemotherapy, the most notable being neutropenia. Neutropenia is the presence of abnormally few white blood cells, leading to increase susceptibility to infection and can require hospitalization and need for intravenous antibiotics and is sometimes fatal. Febrile neutropenia (FN) can also be associated with treatment delays and dose reductions, potentially compromising treatment efficacy. Patients can receive medication to reduce the risk of FN such as Neupogen (filgrastim) as a daily injection for 5, 7 or 10 days. Since there is genuine uncertainty among healthcare professionals as to which administration schedule of Neupogen is the best for patients, this randomized trial compared 5, 7 or 10 days of Neupogen.

Sites: Cancer Centre of Southeastern Ontario (Kingston) London Health Sciences Centre Northeast Cancer Centre (Sudbury) Southlake Regional Health Centre (Newmarket) The Ottawa Hospital Thunder Bay Regional Health Sciences Centre

Tags: Early stage Breast Cancer


Systematic Review:

  • Primary Febrile Neutropenia Prophylaxis for Patients Who Receive FEC-D Chemotherapy for Breast Cancer: A Systematic Review. Fernandes et al, 2018.  PMID: 30241156

Patient and Physician Surveys:

  • Filgrastim use in patients receiving chemotherapy for early-stage breast cancer-a survey of physicians and patients. Hilton et al, 2018. PMID: 29411131

Clinical Trial results:

  • A multi-center pragmatic, randomized, feasibility trial comparing standard of care schedules of filgrastim administration for primary febrile neutropenia prophylaxis in early-stage breast cancer. Ibrahim et al, 2017. PMID: 29214415
  • A multi-centre, randomised trial comparing schedules of G-CSF (filgrastim) administration for primary prophylaxis of chemotherapy-induced febrile neutropenia in early stage breast cancer.  Clemons et al, 2020. PMID: 32325257