Pan-European Survey Reveals Concerning Rates of Chemotherapy-Induced Neutropenia

Up to 30 % of patients surveyed experienced an infection during the course of their chemotherapy, while use of prophylactic treatment varies widely in clinical practice

BRUSSELS, November 26 - The risk of neutropenic infections poses an additional threat to cancer
patients undergoing chemotherapy, at a time when a patient's emotional and
physical energy has to be focused on fighting the primary disease. According
to the results of a new pan-European survey amongst patients and nurses,
nearly a third of patients (30 percent) surveyed experienced an infection,
during the course of their chemotherapy, 46 percent of which were associated
with neutropenia or febrile neutropenia.

The Preventing Febrile Neutropenia - Staying on Track with Chemotherapy
survey, presented today,(1) found that 37 percent of patients with an
infection needed to delay or change their chemotherapy as a result. Nine out
of ten (92 percent) of nurses questioned, agreed that prevention of febrile
neutropenia and infection is very important to achieve a successful outcome
for patients undergoing chemotherapy.

When questioned about factors that may impact chemotherapy, almost all
(96 percent) of the nurse respondents agreed that neutropenic infection can
cause a delay in treatment, with interruptions in chemotherapy impacting
overall effectiveness of the treatment (63 percent). Six out of ten nurses
felt that a patient's chances of successful cancer treatment may be lower if
there need to be changes in chemotherapy treatment as a result of febrile
neutropenia or neutropenic infection and over half of nurses questioned
agreed that lowering the dose may have an impact on the outcome of treatment,
even if the dose is adjusted or increased later on (56 percent).

The survey was conducted by The European Oncology Nursing Society (EONS)
in nine European countries to explore current perceptions and issues relating
to cancer therapy and infection, specifically neutropenia/febrile neutropenia
(FN).

"Cancer patients often undergo intense and frequent chemotherapy, making
them vulnerable to severe or febrile neutropenia and its consequences, such
as infection. The survey results suggest that the risk of neutropenia and the
impact this can have on patients' clinical care and quality of life must be
taken even more seriously," said Kay Leonard, European Oncology Nursing
Society (EONS) Board Member. "Despite the widespread availability of
prophylactic treatments, a significant number of patients continue to be
affected by neutropenia and its consequences," she added.

Neutropenia means that there is an abnormally low level of
infection-fighting white blood cells (neutrophils) in the body and it is a
common and potentially dangerous side effect of some chemotherapies, leading
to a heightened risk of infection, sometimes life-threatening amongst cancer
patients. Severe neutropenia and febrile neutropenia require hospitalisation
in high-risk cases: nearly 1 in 10 patients hospitalised with febrile
neutropenia, die as a result of it. A secondary outcome of febrile
neutropenia can be the delay in scheduled chemotherapy, keeping patients from
getting their full dose at the right time with a potential impact on
chemotherapy outcome. Hospitalisation also results in an interruption to a
patient's daily life, versus their planned chemotherapy treatment, which
usually takes place on an outpatient basis.

Treatments are available to prevent and manage chemotherapy-induced
infections and significant progress has been made in the development of
"proactive" therapies to help manage side effects of chemotherapy. Guidelines
developed by the European Organization for Research and Treatment of Cancer
(EORTC) state that recombinant human granulocyte colony-stimulating factors
(G-CSFs) are available to treat or prevent neutropenia and therefore reduce
associated complications.(2) This is reflected in 39 percent of nurse survey
respondents who confirmed using G-CSFs prophylactically to prevent febrile
neutropenia in patients receiving chemotherapy. An additional 22 percent of
nurses reported using both G-CSFs and antibiotics.

However, nurse respondents expressed concerns regarding patients'
compliance to treatment (58 percent were somewhat, very or extremely
concerned). Moreover, it was reported by patients in the survey that access
to and provision of treatments that prevent infection varies widely across
Europe.

"Given the serious nature of neutropenic infections, it is vital that
patients are provided with information about their risk of neutropenia and
developing an infection, as a result of their chemotherapy. When prescribed
prophylaxis with daily G-CSF, it is essential to ensure compliance to
treatment to achieve the best possible outcome of the primary chemotherapy.
Thus, a G-CSF which can be administered once per chemotherapy cycle, may
offer compliance advantages," said Dr. Matti S. Aapro, Director,
Multidisciplinary Oncology Institute, Genolier, Switzerland.

A significant number of patient respondents did not appear to fully
understand their risk of developing febrile neutropenia. Conversely, almost
two-thirds (64 percent) of nurses questioned stated that they discuss the
management of fever during and after therapy with their patients, which
suggests a need for improvements in communication between patients and their
healthcare providers.

The Preventing Febrile Neutropenia - Staying on Track with Chemotherapy
survey was conducted by PatientView in collaboration with The European
Oncology Nursing Society (EONS), and is sponsored by Amgen. This research is
representative of the company's ongoing efforts to assess better ways to
reduce neutropenia and its consequences in patients with cancer.

NOTES TO EDITORS:

About the survey

The survey was conducted by The European Oncology Nursing Society (EONS)
in association with PatientView, amongst 300 patients and 157 nurses in nine
European countries (Austria, Belgium, France, Germany, Italy, Spain, Sweden,
UK & Ireland) to explore current perceptions and issues relating to cancer
therapy and infection, specifically Neutropenia/Febrile Neutropenia. The
current results are 'interim' and at the halfway mark in the survey period,
although overall trends are expected to remain the same. The aim is to survey
a total of 500 patients.

About The European Oncology Nursing Society (EONS)

The European Oncology Nursing Society (EONS) has provided professional
support to cancer nurses since 1984. Registered as an independent, not for
profit organisation, EONS represents the voice of more than 22,000 cancer
nurses from 29 European countries. With our headquarters in Brussels, EONS
assists in the promotion of healthy European communities through the
development of activities that educate, support and empower cancer nurses,
enabling them to provide the best possible patient care.

Visit us now at our website: www.cancernurse.eu or contact the EONS
office at: eons.secretariat@cancernurse.eu or +32-2-779-9923.

About PatientView

PatientView is an independent researcher and publisher that works closely
with patient organisations. PatientView has conducted hundreds of surveys of
patients and patient organisations over the years. These surveys, and the
projects they have informed, have contributed to changes in government
policy, promoted patient-public consultation, supported academics and
researchers, and raised public awareness of specific disease areas.

About Amgen

Amgen discovers, develops and delivers innovative human therapeutics. A
biotechnology pioneer since 1980, Amgen was one of the first companies to
realise the new science's promise by bringing safe and effective medicines
from lab, to manufacturing plant, to patient. Amgen therapeutics have changed
the practice of medicine, helping millions of people around the world in the
fight against cancer, kidney disease, rheumatoid arthritis, and other serious
illnesses. With a deep and broad pipeline of potential new medicines, Amgen
remains committed to advancing science to dramatically improve people's
lives. To learn more about our pioneering science and our vital medicines,
visit www.amgen.com.

(1) Amgen data on file. Preventing Febrile Neutropenia - Staying on Track
with Chemotherapy survey. Conducted by PatientView: Launched end-September
2009 (ongoing)

(2)
www.eortc.be/services/doc/highlights/press_release_febrile_neutro.htm

Media, +41 (0)41-369-25-30, tviering at amgen.com, for Amgen