Single Center Experiences with Pegfilgrastim as Secondary Prophylaxis

Single Center Experiences with Pegfilgrastim as Secondary Prophylaxis

OBJECTIVEPegfilgrastim is a new generation on granulocyte-colony stimulating factors (G-CSF) with different pharmacokinetic properties. In this study, we aimed to evaluate the results of the use of pegfilgrastim as secondary prophylaxis.METHODSBetween November 2016 and June 2019, a retrospective analysis of the patients who used pegfilgrastim with solid malignancies treated in the University of Health Sciences, Dr. A. Y. Ankara Oncology Hospi-tal Department of Medical Oncology was performed.RESULTSA total of 148 patients were evaluated, and 33 (22.2%) of them were in the geriatric population (age>65). The majority of the patients (n=97, 65.5%) were diagnosed with breast carcinoma, and 93.2% (n=138) of all patients were treated with the intermediate-risk chemotherapy regimen. Pegfilgrastim was used as secondary prophylaxis for all of the patients. Despite pegfilgrastim prophylaxis, febrile neutropenia (FN) developed in four (2.7%) patients. Chemotherapy delay due to afebrile neutropenia occurred in eight patients (5.4%), and neutrophil counts returned to normal in mean 4.0 (3-5) days. When side ef-fects were evaluated, 31 patients (20.9%) had pegfilgrastim-induced bone pain and two patients (1.3%) had redness in the injection site.CONCLUSIONThe low incidence of FN and chemotherapy delay, even in secondary prophylaxis with pegfilgrastim, suggests that pegfilgrastim is an effective agent in neutropenia prophylaxis.

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  • 1. Hashiguchi Y, Kasai M, Fukuda T, Ichimura T, Yasui T, Sumi T. Chemotherapy-induced neutropenia and febrile neutropenia in patients with gynecologic malignancy. Anticancer Drugs 2015;26(10):1054–60.
  • 2. Green MD, Koelbl H, Baselga J, Galid A, Guillem V, Gascon P, et al. A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy. Ann Oncol 2003;14(1):29–35.
  • 3. Dinan MA, Hirsch BR, Lyman GH. Management of Chemotherapy-Induced Neutropenia: Measuring Quality, Cost, and Value. J Natl Compr Canc Netw 2015;13(1):e1–7.
  • 4. Dale DC. Colony-stimulating factors for the management of neutropenia in cancer patients. Drugs 2002;62(Suppl 1):1–15.
  • 5. Biganzoli L, Untch M, Skacel T, Pico JL. Neulasta (pegfilgrastim): a once-per-cycle option for the management of chemotherapy-induced neutropenia. Semin Oncol 2004;31(3 Suppl 8):27–34.
  • 6. Almenar D, Mayans J, Juan O, Bueno JM, Lopez JI, Frau A, et al. Pegfilgrastim and daily granulocyte colony-stimulating factor: patterns of use and neutropenia-related outcomes in cancer patients in Spain--results of the LEARN Study. Eur J Cancer Care (Engl) 2009;18(3):280–6.
  • 7. Kuderer NM, Dale DC, Crawford J, Lyman GH. Impact of primary prophylaxis with granulocyte colonystimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol 2007;25(21):3158–67.
  • 8. Yang BB, Savin MA, Green M. Prevention of chemotherapy-induced neutropenia with pegfilgrastim: pharmacokinetics and patient outcomes. Chemotherapy 2012;58(5):387–98.
  • 9. Green MD, Koelbl H, Baselga J, Galid A, Guillem V, Gascon P, et al. A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily. Ann Oncol 2003;14(1):2935.
  • 10. Siena S, Piccart MJ, Holmes FA, Glaspy J, Hackett J, Renwick JJ. A combined analysis of two pivotal randomized trials of a single dose of pegfilgrastim per chemotherapy cycle and daily Filgrastim in patients with stage II-IV breast cancer. Oncol Rep 2003;10(3):715–24.
  • 11. Vogel CL, Wojtukiewicz MZ, Carroll RR, Tjulandin SA, Barajas-Figueroa LJ, Wiens BL, et al. First and Subsequent Cycle Use of Pegfilgrastim Prevents Febrile Neutropenia in Patients With Breast Cancer: A Multicenter, Double-Blind, Placebo-Controlled Phase III Study. J Clin Oncol 2005 20;23(6):1178–84.
  • 12. Holmes FA, O’Shaughnessy JA, Vukelja S, Jones SE, Shogan J, Savin M, et al. Blinded, randomized, multicenter study to evaluate single administration pegf ilgrastim once per cycle versus daily filgrastim as an adjunct to chemotherapy in patients with high-risk stage II or stage III/IV breast cancer. J Clin Oncol 2002;20(3):727–31.
  • 13. Zamboni WC. Pharmacokinetics of pegfilgrastim. Pharmacotherapy 2003;23(8 Pt 2):9S–14S.
  • 14. Klastersky J, de Naurois J, Rolston K, Rapoport B, Maschmeyer G, Aapro M, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol 2016;27(suppl 5):v111–v8.
  • 15. Salmon JP, Smakal M, Karanikiotis C, Wojtukiewicz MZ, Omnes Y, DeCosta L, et al. Febrile neutropenia (FN) and pegfilgrastim prophylaxis in breast cancer and non-Hodgkin’s lymphoma patients receiving high (> 20%) FN-risk chemotherapy: results from a prospective observational study. Support Care Cancer 2019;27(4):1449–57.
  • 16. Eckstrom J, Bartels T, Abraham I, Patel H, Elquza E, Scott AJ, et al. A single-arm, retrospective analysis of the incidence of febrile neutropenia using sameday versus next-day pegfilgrastim in patients with gastrointestinal cancers treated with FOLFOX or FOLFIRI. Support Care Cancer 2019;27(3):873–8.
  • 17. Pawloski PA, Larsen M, Thoresen A, Giordana MD. Pegfilgrastim use and bone pain: a cohort study of community-based cancer patients. J J Oncol Pharm Pract 2016;22(3):423–9.
  • 18. Xu H, Gong Q, Vogl FD, Reiner M, Page JH. Risk Factors For Bone Pain Among Patients Receiving Myelosuppressive Chemotherapy and Primary Prophylactic Pegfilgrastim. Support Care Cancer. 2016;24(2):723–30.
Türk Onkoloji Dergisi-Cover
  • ISSN: 1300-7467
  • Başlangıç: 2015
  • Yayıncı: Ali Cangül
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