Risk assessment of febrile neutropenia and evaluation of G-CSF use in patients with cancer: a real-life study

Aras, Elif; Bayraktar-Ekincioglu, Aygin; Kılıçkap, Saadettin

doi:10.1007/s00520-019-04879-x

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…Considering the wide use of risk indexes for clinical decision-making, it would be important to evaluate the performance of the most frequently used tools related to the choice of Peg lgrastim administration option. Moreover, other studies have evaluated the relevance of FN risk assessment in order to avoid unnecessary treatment with Peg lgrastim to optimize patients' welfare and clinical outcomes [17]. Evaluating these variables exceeds the scope of the present study and is proposed as a potential investigational objective for future studies.…”

Section: Discussionmentioning

confidence: 96%

Health Professionals’ Preferences With the Use of Pegfilgrastim On-Body Injector At Oncology Centers in 8 Cities in Colombia.

Larrarte-Gonzalez,

Pineda-Posada,

Gaitan

et al. 2021

Preprint

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Purpose Febrile neutropenia associated with some chemotherapy regimens can lead to potentially fatal complications and high health care costs. Administration of Pegfilgrastim 27 hours after chemotherapy, using an On-Body Injector (OBI), may be more convenient for cancer patients and physicians. This study aims to describe physician and nurse preferences regarding options for administration of Pegfilgrastim at cancer centers, the demographics of the study population and characteristics of participating cancer centers. We aim to determine the conditions and chemotherapy schemes for which Pegfilgrastim is most frequently prescribed. Methods Observational, descriptive, cross-sectional study and survey, conducted between 2019 and 2020. It included 60 participants who were contacted and surveyed via telephone. Results Information from 60 participants was analyzed. It was found that 35% of the respondents are haemato-oncologists, oncologists or hematologists, 30% general practitioners, and 35% are other healthcare professionals (i.e., nurse, oncology nurse and head nurse). 48.02% of professionals give priority to the use of OBI to treat patients at home; among the reasons for this choice the patient's transportation limitations and the release of the nursing staff to attend to another patient in the patient's absence stand out. Conclusions The present study is the first one in Colombia that sought the preferences of healthcare professionals with the use of Neulastim (OBI) compared to pre-filled syringes for the administration of Pegfilgrastim. Our results suggest OBI is the preferred alternative by most HCPs and a good resource optimization strategy in the context of cancer patients’ health care in Colombia.

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Section: Discussionmentioning

confidence: 96%

Health Professionals’ Preferences With the Use of Pegfilgrastim On-Body Injector At Oncology Centers in 8 Cities in Colombia.

Larrarte-Gonzalez,

Pineda-Posada,

Gaitan

et al. 2021

Preprint

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“…Quantification of the risk associated with patient-related factors and neutropenic events is essential for clinical decision-making as it leads to better clinical outcomes, fewer complications, and closer adherence to treatment protocols [21]. It also prevents patients from being inadequately or unnecessarily treated [22]. Current guidelines suggest assessing FN risk at the start of each chemotherapy cycle in order to prevent or better manage the condition if it arises.…”

Section: Clinical Impact Of Fn On Patient Management (When It Affects...mentioning

confidence: 99%

Supportive therapies in the prevention of chemotherapy-induced febrile neutropenia and appropriate use of granulocyte colony-stimulating factors: a Delphi consensus statement

Adamo

Antonuzzo

Danova

et al. 2022

Support Care Cancer

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Purpose Data indicate that the use of prophylactic granulocyte colony-stimulating factors (G-CSFs) for chemotherapy-induced febrile neutropenia (FN) in routine practice is not consistent with guideline recommendations. The initiative “supportive care for febrile neutropenia prevention and appropriateness of G-CFS use” was undertaken to address the issue of inappropriate prescription of G-CSFs and to improve guideline adherence in the treatment of FN. Methods In a two-round Delphi procedure, 36 medical oncologists reviewed clinically relevant recommendations on risk assessment, the appropriate use of G-CSFs, and the prevention of FN based on available literature and individual clinical expertise. Results The consensus was reached on 16 out of 38 recommendations, which are backed by evidence from randomised clinical trials and routine clinical practice. The medical oncologists agreed that the severity of neutropenia depends on patients’ characteristics and chemotherapy intensity, and therefore, the risk of severe neutropenia or FN should be assessed at each chemotherapy cycle so as to initiate prophylaxis with G-CSFs if required. The use of biosimilar G-CSFs, with similar efficacy and safety profiles to the originator biologic, has improved the availability and sustainability of cancer care. The timing of supportive therapy is crucial; for example, long-acting G-CSF should be administered 24–72 h after chemotherapy administration. Each biological agent has a recommended administration dose and duration, and it is important to follow these recommendations to avoid complications associated with under-prophylaxis. Conclusion It is hoped that these statements will help to increase adherence to guideline recommendations for appropriate G-CSF use and improve patient care.

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“…In fact, various studies have shown that G-CSFs tend to be overused in patients administered low-risk chemotherapies (risk of FN <10% or 10%-20%) and underused in those on high-risk regimens (risk of FN >20%). [17][18][19] Indeed, the use of G-CSFs in clinical practice, as primary and secondary prophylaxes, is driven by various factors including the convenience and cost of G-CSFs, availability of biosimilars and the clinical evidence for the benefit of G-CSFs. 14 A better understanding of the factors that influence the choice of G-CSF will allow optimisation of G-CSF use in clinical practice and consequently improve FN management in patients with cancer .…”

Section: What Are the New Findings?mentioning

confidence: 99%

Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment

Scotté

Simon

Laplaige

et al. 2021

BMJ Support Palliat Care

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ObjectivesFebrile neutropenia (FN) commonly occurs during cancer chemotherapy. Prophylaxis with granulocyte colony-stimulating factors (G-CSFs) is known to reduce the severity and incidence of FN and infections in patients with cancer. Despite the proven efficacy, G-CSFs are not always prescribed as recommended. We performed a discrete-choice experiment (DCE) to determine what factors drive the physician preference for FN prophylaxis in patients with cancer undergoing chemotherapy.MethodsAttributes for the DCE were selected based on literature search and on expert focus group discussions and comprised pain at the injection site, presence of bone pain, associated fever/influenza syndrome, efficacy of prophylaxis, biosimilar availability, number of injections per chemotherapy cycle and cost. Oncologists, in a national database, were solicited to participate in an online DCE. The study collected the responses to the choice scenarios, the oncologist characteristics and their usual prescriptions of G-CSFs in the context of breast, lungs and gastrointestinal cancers.ResultsOverall, the responses from 205 physicians were analysed. The physicians were mainly male (61%), with ≤20 years of experience (76%) and working only in public hospitals (73%). The physicians prescribe G-CSF primary prophylaxis for 32% of patients: filgrastim in 46% and pegfilgrastim in 54%. The choice of G-CSF for primary and secondary prophylaxis was driven by cost and number of injections. Biosimilars were well accepted.ConclusionCost and convenience of G-CSF drive the physician decision to prescribe or not G-CSF for primary and secondary FN prophylaxes. It is important that these results be incorporated in the optimisation of G-CSF prescription in the clinical setting.

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Risk assessment of febrile neutropenia and evaluation of G-CSF use in patients with cancer: a real-life study

Cited by 11 publications

References 18 publications

Health Professionals’ Preferences With the Use of Pegfilgrastim On-Body Injector At Oncology Centers in 8 Cities in Colombia.

Health Professionals’ Preferences With the Use of Pegfilgrastim On-Body Injector At Oncology Centers in 8 Cities in Colombia.

Supportive therapies in the prevention of chemotherapy-induced febrile neutropenia and appropriate use of granulocyte colony-stimulating factors: a Delphi consensus statement

Febrile neutropenia prophylaxis, G-CSF physician preferences: discrete-choice experiment

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