Evidence map›Paper›PMID 39934515›Full record

SynthesisInternational journal of clinical oncology2025

Efficacy and safety of dose-dense chemotherapy for early-stage breast cancer under prophylactic pegfilgrastim administration: a systematic review and meta-analysis from clinical practice guidelines for the use of G-CSF 2022.

Takamichi Yokoe, Tetsuhiro Yoshinami, Kazuki Nozawa, Yukinori Ozaki, Hiroshi Nishio, Kenji Tsuchihashi, Eiki Ichihara, Yuji Miura, Makoto Endo, Shingo Yano and 17 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Takamichi YokoeDepartment of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 161-0016, Japan. takamichi.yokoe@gmail.com.ORCID http://orcid.org/0000-0001-7068-7117
Tetsuhiro YoshinamiDepartment of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, 565-0871, Japan.
Kazuki NozawaDepartment of Advanced Clinical Research and Development, Graduate School of Medical Sciences, Nagoya City University, Aichi, Japan.
Yukinori OzakiDepartment of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Hiroshi NishioDepartment of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Kenji TsuchihashiDepartment of Hematology, Oncology and Cardiovascular Medicine, Fukuoka, Japan.
Eiki IchiharaCenter for Clinical Oncology, Okayama University Hospital, Okayama, Japan.
Yuji MiuraDepartment of Medical Oncology, Toranomon Hospital, Tokyo, Japan.
Makoto EndoDepartment of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
Shingo YanoDivision of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Dai MaruyamaDepartment of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Nobuyuki SusumuDepartment of Obstetrics and Gynecology, International University of Health and Welfare Narita Hospital, Chiba, Japan.
Munetaka TakekumaDeparment of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan.
Takashi MotohashiDepartment of Obstetrics and Gynecology, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Mamoru ItoDepartment of Hematology, Oncology and Cardiovascular Medicine, Fukuoka, Japan.
Eishi BabaDepartment of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Nobuaki OchiDepartment of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan.
Toshio KuboDepartment of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan.
Keita UchinoDepartment of Medical Oncology, NTT Medical Center Tokyo, Tokyo, Japan.
Takahiro KimuraDepartment of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Yutaro KamiyamaDepartment of Clinical Oncology/Hematology, The Jikei University School of Medicine, Tokyo, Japan.
Shinji NakaoDepartment of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.
Shinobu TamuraDepartment of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan.
Hitomi NishimotoDepartment of Nursing, Okayama University Hospital, Okayama, Japan.
Yasuhisa KatoDepartment of Drug Information, Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, Kanagawa, Japan.
Atsushi SatoDepartment of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Toshimi TakanoDepartment of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn early-stage breast cancer, dose-dense chemotherapy, which involves the administration of standard doses at shorter intervals, is safer when administered with granulocyte colony-stimulating factor (G-CSF) to mitigate chemotherapy-induced neutropenia. This study aimed to thoroughly evaluate the advantages and disadvantages of dose-dense regimens based on the use of G-CSF.

methodsA systematic review was conducted according to the "Minds Handbook for Clinical Practice Guideline Development" using PubMed, Ichushi-Web, and the Cochrane Library databases. Randomized controlled trials (RCTs) and cohort studies assessing dose-dense chemotherapy with prophylactic pegfilgrastim administration in early-stage breast cancer were included. Outcomes included overall survival, event-free survival, incidence of febrile neutropenia, quality of life (QOL), and pain. Meta-analyses were performed on outcomes with sufficient data.

resultsOur literature search identified 23 RCTs. Overall survival and event-free survival showed a trend favoring dose-dense therapy (hazard ratio, 0.90, 0.90; 95% confidence interval [CI] 0.78 - 1.03, 0.80 - 1.01; p = 0.13; 0.07, respectively). The incidence of febrile neutropenia was similar between the groups (odds ratio, 0.90; 95% CI 0.58 - 1.40; p = 0.65). Mortality due to infection could not be compared owing to the small number of events. Pain increased with dose-dense therapy (odds ratio 2.57; 95% CI 1.00 - 6.62; p = 0.05), likely from G-CSF-induced bone pain. Only one study examined QOL, showing a decline with chemotherapy that recovered after treatment.

conclusionsDose-dense chemotherapy trended toward improved survival outcomes without increasing the risk of infection, although pain increased. Further research should identify the specific subgroups that most benefit from dose-dense regimens. More data are needed on the impact on QOL.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsFilgrastimGranulocyte Colony-Stimulating FactorPolyethylene GlycolsChemotherapy-Induced Febrile NeutropeniaFemaleHumansNeoplasm StagingPractice Guidelines as TopicQuality of LifeRandomized Controlled Trials as TopicFilgrastimGranulocyte Colony-Stimulating FactorpegfilgrastimPolyethylene GlycolsDose-dense chemotherapyEarly-stage breast cancerGranulocyte colony-stimulating factorNeutropeniaProphylactic pegfilgrastim

Identifiers

PMID39934515

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.