Abstract
e11527 Background: Proper dosing of anticancer drugs is complex due to narrow therapeutic margins and substantial inter-individual variability (IIV) in treatment effects. Neutropenia is the dose-limiting toxicity of anthracycline/cyclophosphamide-based chemotherapy (ACC). In practice, an inappropriate low dose of ACC is not routinely detected. Retrospective data suggest a strong association between treatment-related neutropenia and survival in breast cancer patients (1-4). Therefore, we started a prospective study of neutrophil-guided dose escalation of ACC in 30 female patients with breast cancer. Methods: Breast cancer patients referred for 3-weekly ACC were invited to participate. After informed consent, the 1st treatment cycle was administered in a standard BSA-based dose. Absolute neutrophil count (ANC) was measured at baseline and at days 8, 11 and 15. For patients with grade 0-2 neutropenia and no other dose-limiting toxicity, we intended a 10-25% dose escalation (using a pre-specified dosing algor...
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