A randomized multicenter phase II trial of mecapegfilgrastim single administration versus granulocyte colony-stimulating growth factor on treating chemotherapy-induced neutropenia in breast cancer patients

Wu, Biao; Hu, Xichun; Liu, Jinping; Zhang, Tao; Li, Funian; Sun, Bing; Cai, Li; Li, Xinzheng; Chen, Zhiyue; Yang, Qing; Jiang, Zefei

doi:10.21037/atm.2019.04.10

Cited by 15 publications

(27 citation statements)

References 21 publications

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“…Only five studies [21,22,[24][25][26] provided information on the incidence of grade ≥ 3 neutropenia. When we input all the data from these studies into the RevMan software, we found that the heterogeneity among the five studies was significant (P = 0.003, I 2 = 75%); therefore, sensitivity analysis of the five trials was performed.…”

Section: Results Of Individual Studies and Synthesis Of The Resultsmentioning

confidence: 99%

“…The results showed that the use of PEGylated G-CSF did not result in a significantly shorter duration of grade 4 neutropenia compared with that of G-CSF (WMD = − 0.32, 95% CI 0.67 to 003, P = 0.007). When we removed Wang's study [22] from the analysis, the heterogeneity decreased (P = 0.12, I 2 = 49%); however, the data from the Wang's data did not influence the final result (P > 0.05). Thus, although the included studies showed that the use of PEGylated G-CSF resulted a slight improvement in grade 4 neutropenia compared with that of G-CSF, the difference was not significant (Fig.…”

Section: The Duration Of Grade 4 Neutropeniamentioning

confidence: 94%

“…Among the 26 articles, 17 articles were excluded: 7 articles were only an abstract, 1 article was not in English, 4 articles were only related to long-acting G-CSF, 3 articles included patients with other types of cancer, and 2 articles were not RCTs. Thus, nine studies [19][20][21][22][23][24][25][26][27] were ultimately included in our present systematic review. Two of the identified papers were by the same author [19,20]; therefore, we examined the data carefully.…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

“…Four studies [21,22,25,26] provided results for the duration of grade ≥ 3 neutropenia. The heterogeneity among the studies was significant (P < 0.00001, I 2 = 94%); however, none of the studies in our analysis significantly influenced the heterogeneity, so we used the random effects model to analyze these data.…”

Section: The Duration Of Grade ≥ 3 Neutropeniamentioning

confidence: 99%

“…Five studies [19][20][21][22]27] reported the duration of grade 4 neutropenia. There was significant heterogeneity among the studies (P = 0.01, I 2 = 69%), necessitating the use of the random effects model.…”

Section: The Duration Of Grade 4 Neutropeniamentioning

confidence: 99%

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Is PEGylated G-CSF superior to G-CSF in patients with breast cancer receiving chemotherapy? A systematic review and meta-analysis

Zheng

Mei

et al. 2020

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Background PEGylated granulocyte colony-stimulating factor (G-CSF) is a safe alternative to G-CSF to improve chemotherapyinduced neutropenia (CIN). This superiority has resulted in its increased use by physicians; however, the superiority of PEGylated G-CSF for CIN in breast cancer has not been conclusively determined. Objectives To assess the superiority of PEGylated G-CSF for CIN in breast cancer in terms of effectiveness and safety via a systematic review and meta-analysis. Methods A literature search in PubMed, Embase, Cochrane Library, and Web of Science was performed for eligible studies published from database inception to December 2019. All studies comparing PEGylated G-CSF and G-CSF for CIN of breast cancer were reviewed. After literature selection, data extraction and quality assessment were performed by two reviewers independently. Meta-analysis was conducted using Revman, version 5.2. Results Nine randomized controlled trials were finally identified. The publication bias of these studies was acceptable. For the endpoint of effectiveness, analysis of the incidence/duration of grade ≥ 3 neutropenia, the duration of grade 4 neutropenia, the incidence of febrile neutropenia (FN), and the time to absolute neutrophil count recovery showed no advantage of PEGylated G-CSF over G-CSF for CIN of breast cancer (P > 0.05), with the premise of a sufficient dose of G-CSF according to the guidelines. No significant differences in grade 4 adverse events were observed between the groups (P = 0.29), and PEGylated G-CSF did not increase the incidence of skeletal and/or muscle pain compared with G-CSF (P = 0.32). Conclusion PEGylated G-CSF was as effective and safe as G-CSF to reduce CIN in breast cancer but did not show an obvious superiority. However, in clinical practice, PEGylated G-CSF has an obvious advantage in terms of convenience, which could improve patient's quality of life.

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