Evaluating the need for G-CSF in breast cancer patients on chemotherapy

A Randomized Pragmatic Trial Evaluating Omission of Granulocyte Colony-stimulating Factors in Breast Cancer Patients Receiving Paclitaxel Portion of Dose-dense Adriamycin-cyclophosphamide and Paclitaxel Chemotherapy (REaCT-OGF)

Phase 4 Interventional Ottawa Hospital Research Institute · NCT05753618

This study is testing if breast cancer patients on a specific chemotherapy can skip a medication called G-CSF to see if it helps reduce side effects without affecting their treatment success.

Quick facts

PhasePhase 4
Study typeInterventional
Enrollment242 (estimated)
Ages18 Years and up
SexAll
SponsorOttawa Hospital Research Institute Academic / other
Drugs / interventionschemotherapy, cyclophosphamide
Locations3 sites (Kingston, Ontario and 2 other locations)
Trial IDNCT05753618 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to assess whether granulocyte colony-stimulating factors (G-CSF) are necessary for breast cancer patients undergoing the paclitaxel portion of dose-dense adriamycin-cyclophosphamide and paclitaxel chemotherapy. Participants will be randomly assigned to either receive G-CSF or to omit it during treatment. The study seeks to determine if omitting G-CSF can reduce side effects such as bone pain and fever, while still maintaining effective treatment outcomes. The trial builds on previous findings suggesting that it may be safe to forgo G-CSF in this context.

Who should consider this trial

Good fit: Ideal candidates are patients with early-stage or locally-advanced breast cancer receiving neoadjuvant or adjuvant chemotherapy requiring G-CSF prophylaxis.

Not a fit: Patients with metastatic cancer or those who have received prior cytotoxic chemotherapy within the last 5 years may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to reduced side effects and improved quality of life for breast cancer patients undergoing chemotherapy.

How similar studies have performed: Previous studies have suggested that omitting G-CSF during the paclitaxel portion of chemotherapy is safe and feasible, indicating potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients with early-stage or locally-advanced breast cancer receiving neoadjuvant or adjuvant DD-AC/T chemotherapy requiring primary febrile neutropenia prophylaxis with G-CSF
* Able to provide verbal consent
* Able to complete questionnaires in English or French

Exclusion Criteria:

* No access to pegfilgrastim or filgrastim prior to randomization
* Metastatic cancer
* Known hypersensitivity to filgrastim or pegfilgrastim or one of its components
* Patients received prior cytotoxic chemotherapy within the last 5 years
* Patients with uncontrolled inter-current illness that would limit compliance with study requirements or other significant diseases or disorders that, in the investigator's opinion, would exclude the subject from participating in the study

Where this trial is running

Kingston, Ontario and 2 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Early-stage Breast CancerFilgrastimPegfilgrastimBone painPaclitaxel
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.