Pegfilgrastim: evidence in support of its use with cytotoxic chemotherapy

Abstract

The advent of granulocyte colony-stimulating factor, in particular filgrastim, in clinical use more than 10 years ago made a significant impact on the management of neutropenia and its complications. More recently, the application of pegylation technology has created a second-generation molecule, pegfilgrastim, with significantly altered pharmacokinetic properties. This has allowed for a once per chemotherapy cycle dosing in contrast to the requirement of daily subcutaneous administration for filgrastim. Several randomized trials in nonmyeloid malignancies have proven that a fixed dose of pegfilgrastim 6 mg is at least equivalent to daily filgrastim therapy. Emerging evidence also suggests that pegfilgrastim may be equally employed in the setting of chemotherapy for acute myeloid leukemia, dose-dense chemotherapy and peripheral stem cell mobilization. If confirmed in subsequent Phase III trials, it is likely that pegfilgrastim will eventually succeed filgrastim as the colony-stimulating factor of choice in clinical practice.

Pegfilgrastim for PBSC mobilization and autologous haematopoietic SCT

“…Several economic studies on growth factor therapy, including pegfilgrastim, that have been conducted in cancer patients receiving chemotherapy suggest that pegfilgrastim is cost-effective. [55][56][57][58] However, in general, these studies cannot be extrapolated to the use of pegfilgrastim in the context of SCT. Appropriate studies are needed to address this issue.…”