Pegfilgrastim primary prophylaxis vs. current practice neutropenia management in elderly breast cancer patients receiving chemotherapy

Aapro, Matti; Schwenkglenks, Matthias; Lyman, Gary H.; Pousa, Antonio López; Lawrinson, S.; Skácel, Tomáš; Bacon, Pamela; Minckwitz, Gϋnter von

doi:10.1016/j.critrevonc.2009.06.004

Cited by 26 publications

(13 citation statements)

References 34 publications

(49 reference statements)

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“…A review by Aapro et al 16 showed a generally lower incidence of FN with pegfilgrastim (6%; CI= 2%, 10%) when it was initiated as primary prophylaxis, as compared to the current practice for the management of neutropenia (defined as filgrastim use in any cycle, pegfilgrastim use in any cycle or no G-CSF use) (24%; CI= 16%, 32%). The statistical significance of the difference was, again, not determined.…”

Section: Discussionmentioning

confidence: 95%

Comparison of daily filgrastim and pegfilgrastim to prevent febrile neutropenia in Asian lymphoma patients

Chan¹,

Leng²,

Chiang³

et al. 2010

Asia-Pac J Clncl Oncology

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Section: Discussionmentioning

confidence: 95%

Comparison of daily filgrastim and pegfilgrastim to prevent febrile neutropenia in Asian lymphoma patients

Chan¹,

Leng²,

Chiang³

et al. 2010

Asia-Pac J Clncl Oncology

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“…A fixed pegfilgrastim 6-mg dose provided sufficient neutrophilic support to patients with breast cancer or other malignancies receiving dose-dense chemotherapy regimens (typically using one dose of pegfilgrastim in each 2-week chemotherapy cycle) [83,84,85,86,88]. The use of pegfilgrastim or other G-CSF agents has also been shown to facilitate maintenance of chemotherapy dose intensity in elderly patients [89,90,91]. …”

Section: Chemotherapy-induced Neutropenia Managementmentioning

confidence: 99%

Prevention of Chemotherapy-Induced Neutropenia with Pegfilgrastim: Pharmacokinetics and Patient Outcomes

2012

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Patients receiving cytotoxic chemotherapy are at risk for developing chemotherapy-induced neutropenia (CIN). Filgrastim, a recombinant granulocyte colony-stimulating factor (G-CSF) that stimulates the proliferation, differentiation and function of neutrophils, is approved for the prevention of CIN. To eliminate the burden of daily filgrastim injection, pegfilgrastim, a long-acting form of filgrastim, was developed by covalently attaching a 20-kDa polyethylene glycol molecule to filgrastim to increase molecular size and thus reduce renal elimination. Consequently, neutrophil-mediated clearance is the primary mechanism for pegfilgrastim elimination. Therefore, after a single pegfilgrastim injection following chemotherapy treatment, pegfilgrastim concentration is sustained during neutropenia and decreases with neutrophil recovery. Pegfilgrastim has received marketing authorization approval from many regions to reduce the incidence of CIN based on the similar efficacy and safety of a single injection of 6 mg of pegfilgrastim administered once per chemotherapy cycle and 10 to 11 daily injections of filgrastim at 5 µg/kg. The efficient self-regulating clearance of pegfilgrastim allows administration once per chemotherapy cycle, thereby providing a more convenient treatment regimen than filgrastim.

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“…Of particular importance to the achievement of maximal effectiveness of these agents is the correct administration (given approximately 24 h after chemotherapy and, in the case of the daily GCSFs, delivery of an adequate number of doses until the neutrophil count recovers to the normal range (Amgen 2013a,b; Aapro et al . , von Minckwitz et al . ).…”

Section: Discussionmentioning

confidence: 99%

Healthcare utilisation in patients with breast cancer or non-Hodgkin lymphoma who experienced febrile neutropenia in the Netherlands: a retrospective matched control study using the PHARMO database

Issa

Gelderblom

Lugtenburg

et al. 2014

Eur J Cancer Care (Engl)

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Few data have been published on healthcare resource utilisation associated with chemotherapy-induced febrile neutropenia (FN) in Europe. Using the PHARMO record linkage system, we identified incident adult patients with a primary hospital discharge diagnosis of breast cancer (BC) or non-Hodgkin lymphoma (NHL) from 1998 to 2008. Patients who experienced FN were matched 1:2 non-FN reference patients. Of 1033 BC patients, 80 (8%) had FN and were matched with 160 reference patients; and of 486 NHL patients, 95 (20%) had FN and 89 were matched with 178 reference patients. Significantly more FN patients were hospitalised for any cause than reference patients: BC, 81% vs. 24% (OR 12.6; 95% CI 5.7-27.8); NHL, 82% vs. 44% (OR 6.7; 95% CI 3.3-13.9). Median length of all-cause hospitalisation stay was higher for FN patients: BC, 4.0 vs. 1.0 days; NHL, 8.5 vs. 1.8 days. The median (interquartile range) number of medication treatments was higher for FN patients: BC, 5.5 (4.0-7.5) vs. 2.0 (2.0-4.0); NHL, 8.0 (5.0-11.0) vs. 3.0 (2.0-4.0). In conclusion, FN in patients with BC or NHL had increased healthcare utilisation compared with non-FN patients; thus, efforts to reduce FN are warranted to reduce cost and improve outcomes.

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Pegfilgrastim primary prophylaxis vs. current practice neutropenia management in elderly breast cancer patients receiving chemotherapy

Cited by 26 publications

References 34 publications

Comparison of daily filgrastim and pegfilgrastim to prevent febrile neutropenia in Asian lymphoma patients

Comparison of daily filgrastim and pegfilgrastim to prevent febrile neutropenia in Asian lymphoma patients

Prevention of Chemotherapy-Induced Neutropenia with Pegfilgrastim: Pharmacokinetics and Patient Outcomes

Healthcare utilisation in patients with breast cancer or non-Hodgkin lymphoma who experienced febrile neutropenia in the Netherlands: a retrospective matched control study using the PHARMO database

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