Evidence map›Paper›PMID 40811630›Full record

Trial reportJNCI cancer spectrum2025

REaCT-5G: a randomized trial of bone pain with 5-day filgrastim vs pegfilgrastim for neutropenia in breast cancer.

Terry L Ng, Peter Greenstreet, Carol Stober, Stuart Nicholls, Jennifer Shamess, Natalie Mills, Mohammed Ibrahim, Marie-France Savard, Moira Rushton, Arif Awan and 11 more

Erratum issuedAbstract readRandomized Controlled TrialMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JNCI cancer spectrum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. 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. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors.

Terry L NgDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0001-6128-3137
Peter GreenstreetOttawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-4997-8742
Carol StoberCancer Research Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Stuart NichollsMethodological and Implementation Research Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.ORCID 0000-0003-0485-9069
Jennifer ShamessChamplain Regional Cancer Care Patient and Family Advisory Council, Ottawa, ON, Canada.ORCID 0009-0008-7196-8998
Natalie MillsSt Joseph Family Medical Clinic, Ottawa, ON, Canada.
Mohammed IbrahimDepartment of Medical Oncology, Northern Ontario School of Medicine University, Thunder Bay, ON, Canada.ORCID 0000-0003-2842-6110
Marie-France SavardDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0002-7651-0870
Moira RushtonDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Arif AwanDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0002-8552-6831
Sandeep SehdevDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0001-7434-2263
John HiltonDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Xinni SongDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Parvaneh FallahGerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.ORCID 0000-0001-7885-2009
Nasser AlqahtaniDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Daniel DavoudpourThunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada.ORCID 0009-0003-0039-0782
Kelly DaigleThe Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.
Fiona MacDonaldThe Ottawa Hospital Cancer Centre, Ottawa, ON, Canada.
Lisa VandermeerCancer Research Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.ORCID 0000-0001-5921-1441
Monica TaljaardOttawa Methods Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada.ORCID 0000-0002-3978-8961
Mark ClemonsDivision of Medical Oncology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.ORCID 0000-0001-9392-8219

Funding

Ottawa Hospital Academic Medical Organization
6 · The paper itself

Abstract

backgroundGranulocyte colony-stimulating factors (G-CSFs), including filgrastim and pegfilgrastim, are associated with bone pain, potentially impacting treatment adherence. This study hypothesized that a 5-day regimen of filgrastim would result in less bone pain than single-dose pegfilgrastim in patients receiving chemotherapy for early breast cancer.

methodsIn this multicenter, open-label, randomized controlled trial, patients requiring prophylactic G-CSF during chemotherapy were randomly assigned 1:1 to receive either 5-day filgrastim or pegfilgrastim. The primary outcome was patient-reported bone pain, assessed as area under the curve of daily pain scores (0 = no pain to 10 = worst pain) over the first 5 days following G-CSF in cycle 1. Secondary outcomes included bone pain in cycles 2-4, febrile neutropenia, hospitalizations, chemotherapy delays, dose reductions, early discontinuations, chemotherapy-related deaths, health-related quality of life, and health-care resource utilization.

resultsFrom June 2021 to March 2023, a total of 233 patients were randomly assigned, with 219 analyzed (110 filgrastim and 109 pegfilgrastim) after excluding those who withdrew before receiving treatment. Adjusting for stratification factors and prespecified baseline covariates using repeated measures linear regression, the mean area under the curve (0-40) for cycle 1 bone pain was 10.2 (11.2) for 5-day filgrastim and 10.2 (9.81) for pegfilgrastim, with an adjusted mean difference of 0.70 (95% confidence interval = 1.62 to 3.02; P = .556). Although no clinically significant differences were observed in most secondary outcomes, the 5-day filgrastim group exhibited a numerically higher incidence of febrile neutropenia (6.4% vs 0.9%, P = .065) and hospitalization (10.0% vs 3.7%, P = .106).

conclusionThere was no significant difference in bone pain between 5-day filgrastim and pegfilgrastim.

Indexed as

Breast NeoplasmsFilgrastimNeutropeniaPainPolyethylene GlycolsAdultAgedDrug Administration ScheduleFemaleGranulocyte Colony-Stimulating FactorHumansMiddle AgedQuality of LifeFilgrastimGranulocyte Colony-Stimulating FactorpegfilgrastimPolyethylene Glycols

Identifiers

PMID40811630
PMCPMC12471350

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.