Day 1 pegfilgrastim with dose dense adjuvant chemotherapy: Amelioration of docetaxel neutropenia but not that of doxorubicin/cyclophosphamide. Results from a Sarah Cannon Research Institute pilot study

749 Background: Dose dense chemotherapy, achieved by shortening treatment intervals, has resulted in improved DFS and OS for doxorubicin/cyclophosphamide (AC)→ paclitaxel although with a higher incidence of toxicity, costs, & cytokine support. This pilot evaluates the feasibility and toxicity of dose dense docetaxel (D)→ AC as adjuvant or neoadjuvant therapy, with this sequence selected to minimize the palmar-plantar erythema (PPE) noted with D following anthracyclines. Same day pegfilgrastim (P) was administered for pt convenience. Methods: Eligibility: locally advanced, LN + or high risk LN neg pts (T > 2 cm or T ≥ 1 cm with either: ER/PR neg, GIII histology, age < 35), PS 0–1, normal LVEF, adequate organ function with no metastatic disease. Treatment was D 100 mg/m2 followed by AC (60/600 mg/m2), each for 4 cycles at q14d intervals with P 6 mg sc D1 x 8 cycles. Results: Between 3/4/04 & 7/28/04, 33 pts with median age 52 were enrolled. 31 pts were treated adjuvantly & 2 neoadjuvantly. 23 tumors were LN...