Optimizing the timing of 3.6 mg Pegfilgrastim Administration for Dose-Dense Chemotherapy in Japanese Patients with Breast Cancer

Daisuke Takabatake, Yukiko Kajiwara, Shoichiro Ohtani, Yoko Suzuki, Mari Yamamoto, Shinichiro Kubo, Masahiko Ikeda, Mina Takahashi, Fumikata Hara, Kenjiro Aogi, Shozo Ohsumi, Yutaka Ogasawara, Yoshitaka Nishiyama, Hajime Hikino, Kinya Matsuoka, Tadahiko Shien, Naruto Taira, Hiroyoshi Doihara

Research output: Contribution to journalArticlepeer-review


Perioperative dose-dense chemotherapy (DDCT) with pegfilgrastim (Peg) prophylaxis is a standard treatment for high-risk breast cancer. We explored the optimal timing of administration of 3.6 mg Peg, the dose approved in Japan. In the phase II feasibility study of DDCT (adriamycin+cyclophosphamide or epirubicin+cyclophosphamide followed by paclitaxel) for breast cancer, we investigated the feasibility, safety, neutrophil transition, and optimal timing of Peg treatment by administering Peg at days 2, 3, and 4 post-chemotherapy (P2, P3, and P4 groups, respectively). Among the 52 women enrolled, 13 were aged > 60 years. The anthracycline sequence was administered to P2 (n=33), P3 (n=5), and P4 (n=14) patients, and the taxane sequence to P2 (n=38) and P3 (n=6) patients. Both sequences showed no interaction between Peg administration timing and treatment discontinuation, treatment delay, or dose reduction. However, the relative dose intensity (RDI) was significantly different among the groups. The neutrophil count transition differed significantly among the groups receiving the anthracycline sequence. However, the neutrophil count remained in the appropriate range for both sequences in the P2 group. The timing of Peg administration did not substantially affect the feasibility or safety of DDCT. Postoperative day 2 might be the optimal timing for DDCT.

Original languageEnglish
Pages (from-to)357-362
Number of pages6
JournalActa medica Okayama
Issue number3
Publication statusPublished - 2021


  • breast cancer
  • dose-dense chemotherapy
  • pegfilgrastim

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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