Optimal timing for pegfilgrastim administration in Japanese breast cancer patients receiving intermediate-risk chemotherapies

Abstract

Background Pegfilgrastim is widely used for prophylaxis of febrile neutropenia (FN) in cancer patients receiving chemotherapies. However, the optimal timing of pegfilgrastim administration has not been established. Objective We investigated the effect of the timing of pegfilgrastim administration on the prevention of FN in patients with breast cancer undergoing intermediate-risk chemotherapies. Method We retrospectively analysed the incidence of FN in patients with breast cancer treated at our institution with intermediate-risk chemotherapies and primary or secondary prophylactic pegfilgrastim between 2015 and 2017. The impact of the timing of pegfilgrastim administration on the incidence of FN was evaluated by univariate and multivariate logistic regression analyses. Results Overall, 87 patients received a total of 318 chemotherapy cycles with pegfilgrastim, and 14 patients (16%) experienced FN. In univariate analyses, day 2 pegfilgrastim administration, age of > 65 years, baseline haemoglobin < 12 g/dL, prior history of FN, and presence of recurrent/metastatic disease trended toward an association with FN. Adjustment for these confounding risk factors revealed that day 2 pegfilgrastim administration was associated with a significantly increased risk of FN (odds ratio 11.0, p = 0.009). Conclusion Administrating pegfilgrastim on day 3 or later may prevent FN more effectively among Japanese breast cancer patients receiving intermediate-risk chemotherapies.

Higher incidence of pegfilgrastim-induced bone pain in younger patients receiving myelosuppressive chemotherapy: a real-world experience

“…We selected the following items that could affect the incidence of PIBP: sex (male vs. female), age (< 55 years vs. ≥ 55 years), pre-existing osteoporosis, tumor type [solid cancers (breast cancer and prostate cancer) vs. hematologic cancers], bone metastasis (present vs. absent), opioids (yes vs. no), NSAIDs (yes vs. no), history of prior chemotherapy (yes vs. no), chemotherapy type (adjuvant therapy vs. chemotherapy alone), type of prophylaxis for FN (primary vs. secondary), and timing of pegfilgrastim administration (days 2, 3 vs. 4–7) [ 11 ]. The threshold of 55 years was determined according to the ROC curve with the area under the curve of 0.744 ( p < 0.001).…”

Clinical Safety and Efficacy of Secondary Prophylactic Pegylated G-CSF in Advanced Pancreatic Cancer Patients Treated with mFOLFIRINOX: A Single-center Retrospective Study

“…Second, patients are usually required to revisit the hospital for Peg G administration. To overcome this issue, Peg G has been administered on the same day as chemotherapy in some clinical trials, which resulted in a higher incidence of FN than with administration a few days after completing chemotherapy (48, 49).…”