Granocyte-colony stimulating factor (G-CSF) has significant efficacy as secondary prophylaxis of chemotherapy-induced neutropenia in patients with solid tumors: results of a prospective study.

Abstract

AIM:

To carry out a prospective, multicenter and observational study describing prophylactic strategies [cycle delay, dose-reduction, (G-CSF) prescription] to prevent recurrence of neutropenic events (NE) in patients with solid tumors, and identify potential predictive factors of NE recurrence.

PATIENTS AND METHODS:

Patients ≥18 years old with an NE in a previous chemotherapy cycle (cycle A) without G-CSF support, followed for four cycles (B to E) were included in the study. NE was defined as any neutropenia grade 1-4, febrile or not, which impacted on subsequent chemotherapy cycles (cycle delay, or reduction, or prophylactic G-CSF).

RESULTS:

Data of 548 patients were analyzed, 378 (69%) were female, with a mean (SD) age of 61.7 (12.3) years. WHO PS: 0-1: 88.3%, incidence of breast cancer: 40%, metastatic disease: 53.3%. Following the first NE episode, 44.5% of patients had cycle delay, 22.3% dose reduction and 466 (85%) received prophylactic G-CSF. NE recurrence rates were: 21.2% at cycle B, 18.6% at cycle C, 11.5% at cycle D and 12.9% at cycle E. G-CSF support (hazard ratio: 0.32, 0.24-0.43, p<0.001) was associated with lower NE recurrence. Pegfilgrastim seemed to offer the highest protection (hazard ratio; HR=0.23, 95% CI: 0.16-0.32; p<0.001).

CONCLUSION:

Secondary G-CSF prophylaxis has significant efficacy in reducing the incidence of NE and should be considered as a valuable option.

• Authors: Gilles Freyer, Nicolas Jovenin, Gabriel Yazbek, Christian Villanueva, Amal Hussain, Anne Berthune, Maciej Rotarski, Hèlène Simon, Vincent Boulanger, Michael Hummelsberger, Claire Falandry
• Journal: Anticancer research (Anticancer Res) Vol. 33 Issue 1 Pg. 301-7 (Jan 2013) ISSN: 1791-7530 [Electronic] Greece
• PMID: 23267161 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Antineoplastic Agents
• Granulocyte Colony-Stimulating Factor

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (adverse effects)
• Granulocyte Colony-Stimulating Factor (administration & dosage)
• Humans
• Middle Aged
• Neoplasms (complications, drug therapy)
• Neutropenia (chemically induced, prevention & control)
• Prospective Studies
• Secondary Prevention