<p>December 06, 2010</p><p>Dr. Marc E. Lippman University of Miami Miller School of Medicine Miami, FL, USA</p><p>Re: Effect of Primary Prophylactic G-CSF use on Systemic Therapy Administration for Elderly Breast Cancer Patients</p><p>Dear Dr. Lippman:</p><p>I am pleased to submit the above manuscript for possible publication in the Breast Cancer Research and Treatment journal as an original report. This study for the first time has explored the effects of primary prophylactic use of granulocyte-colony stimulating factors (G-CSF) on successful first course chemotherapy and radiation therapy administration, following diagnosis, in elderly breast cancer patients in real-life clinical settings. The study, for the first time, also explored the effect of duration of primary prophylactic G-CSF use on systemic therapy administration. The findings revealed interesting facts about the clinical value of the primary prophylaxis in improving adherence to recommended systemic therapy among elderly breast cancer patients. We believe that this study will be of considerable interest to the readers of the journal as well as other health care professionals and policy makers.</p><p>The study was performed by me as part of my dissertation and I did not receive funding from any drug company or organization with stakes or financial incentives associated with the drugs analyzed in this study. One of the authors, Dr. Gary Lyman, is a principal investigator on a research grant to Duke University from Amgen, Inc for work completely unrelated with this study or my dissertation. Dr.Lyman is one of the most experienced clinical investigators in this field and thus provided expert advice as a member of my dissertation committee. The results presented in this publication were presented, in part, at the 2010 annual research meeting of Academy Health in Boston, MA. This article is not under consideration for publication elsewhere. All authors participated sufficiently in this submission to take public responsibility for its content. Publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out. Please feel free to contact me at anytime should you require any additional information related to this manuscript. </p><p>We would like to thank the Editor and reviewers for their consideration of this manuscript for publication in the Breast Cancer Research and Treatment.</p><p>Sincerely yours,</p><p>Suja S. Rajan, MHA, MS, PhD Assistant Professor, Department of Clinical Sciences and Administration University of Houston College of Pharmacy 1441 Moursund St, Room 436, Houston, TX 77030 T: 713-795-8352 F: 713-795-8383 E: [email protected]</p>