Study Group to Develop Prediction Model for Neutropenia

ALBANY, NY—A team of leading oncologists and hematologists has begun a study designed to help physicians more accurately predict and manage neutropenia. The Awareness of Neutropenia in Chemotherapy (ANC) Study Group was formed to develop more accurate prediction models for neutropenia.

“We have the tools to prevent neutropenia, but right now it’s very difficult to predict which of our patients will develop this potentially serious condition,” Gary Lyman, MD, MPH, Albany Medical Center, and a study leader, said in a news release announcing the formation of the study group. “It’s not practical to cover our bases by treating everyone preventively, so most oncologists cross their fingers, hope for the best, and treat patients if needed. This is not ideal, for many reasons.”

Members of the study group point to numerous drawbacks associated with the absence of a neutropenia prediction model:

• Regardless of whether it progresses, neutropenia often results in chemotherapy delays or dose reductions that compromise the long-term effectiveness of chemotherapy.

• The increasing complexity and intensity of chemotherapy regimens means that physicians and patients want to minimize the number of medications a patient must take. Rather than treat conditions prophylactically, many physicians and patients will opt to “watch and wait.”

• In one study, patients who experienced a first neutropenia-related dose modification had a 55% chance of having a second event.

“Stated most simply, the objectives of our study are to help oncologists better understand which cancer patients may be at increased risk for developing neutropenia, and, therefore, which will benefit from proactive management strategies,” said David Dale, MD, professor of medicine, University of Washington Medical Center. “Unfortunately, most cancer clinical studies of the past decade have reported only the simplest measures of neutropenia over the short term, so the data we need to make these decisions simply don’t exist right now.”

The ANC study is being directed by three leading US hematologists and oncologists: Dr. Lyman, Dr. Dale, and Jeffrey Crawford, MD, of Duke University Medical Center.

The remainder of the study group will comprise oncologists from around the world, coordinated by a staff of eight researchers at the Albany Medical Center Cancer Center under the direction of Dr. Lyman. The initiative is funded by a research grant from Amgen.

Members of the study group will utilize the strict rules of meta-analysis to collect, analyze, and pool appropriate data from previous chemotherapy trials, including data from the existing medical literature, unpublished studies, and government reports.

Members will contact original investigators as necessary to gain access to previously unreported data, particularly any data relevant to neutropenia.

The group also plans to initiate several new trials focused on special issues related to neutropenia, including the impact of this condition on quality of life, the economic impact of neutropenia, the role of neutropenia in infection-related mortality, the impact of neutropenia-related dose reduction on long-term survival, and the special problems of the elderly in dealing with chemotherapy-induced neutropenia.