Use, misuse, and overuse of white cell growth factors (GF) in community oncology practices in southeastern United States.

Hrushesky, William J. M.; Huff, Dinah Faith Q.; Anthony, Carol; Bobolts, Laura Rose; Armitage, Melissa; Davis, Starkey D.; Bennett, Charles L.; Shimp, William S.; Schorer, Anna E.; Fishman, Marc L.; Dobies, Cristalle; Fishman, Danielle; Fishman, Val; Walton, Robert; Kogler, Jurgen

doi:10.1200/jco.2014.32.15_suppl.9654

Cited by 3 publications

(1 citation statement)

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“…[10][11][12] Despite these recommendations, inappropriate use of G-CSF has been reported. [13][14][15][16][17][18][19][20] Guidelines by the American Society of Clinical Oncology, National Comprehensive Cancer Network (NCCN), and European Organisation for Research and Treatment of Cancer emphasize the importance of evaluating both chemotherapy regimen risk and patient-specific risk factors when evaluating the risk of FN, and hence, the potential need for prophylactic G-CSF use. [10][11][12] Careful evaluation of these risk factors is particularly important in cancer care settings, where FN rates may be greater than in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level

Baig

Somlo

Eisen

et al. 2018

J Oncol Pharm Pract

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Objective Inappropriate granulocyte colony-stimulating factor use with myelosuppressive chemotherapy has been reported. Using the Oncology Services Comprehensive Electronic Records electronic medical record database, prophylactic granulocyte colony-stimulating factor (pegfilgrastim/filgrastim) use in cancer patients was assessed by febrile neutropenia risk level. Methods Patients with nonmetastatic or metastatic breast, head/neck, colorectal, ovarian/gynecologic, lung cancer, or non-Hodgkin's lymphoma who received myelosuppressive chemotherapy from June 2013 to May 2014 were included. Prophylactic granulocyte colony-stimulating factor use with high-risk, intermediate-risk, and low-risk chemotherapy and distribution of National Comprehensive Cancer Network risk factors with intermediate-risk regimens were assessed. Results Overall, 86,189 patients received ∼4.2 million chemotherapy cycles (high risk, 9%; intermediate risk, 48%; low risk, 43%). Prophylactic granulocyte colony-stimulating factor was given in 24% of cycles (high risk, 59%; intermediate risk, 29%; low risk, 11%). For nonmetastatic solid tumors, granulocyte colony-stimulating factor was given in 78% (high risk), 31% (intermediate risk), and 6% (low risk) of cycles. For metastatic solid tumors or non-Hodgkin's lymphoma, granulocyte colony-stimulating factor was given in 50% (high risk), 27% (intermediate risk), and 11% (low risk) of cycles. Among patients receiving intermediate-risk regimens with granulocyte colony-stimulating factor, febrile neutropenia risk factors were identified in 56% (95% confidence interval, 51.1-60.9%) of patients with nonmetastatic solid tumors (n = 400) and in 70% (64.5-73.5%) of patients with metastatic solid tumors or non-Hodgkin's lymphoma (n = 400). Conclusion Prophylactic granulocyte colony-stimulating factor use was appropriately highest for high-risk regimens and lowest for low-risk regimens yet still potentially underused in high risk regimens, overused in low-risk regimens, and not appropriately targeted in intermediate-risk regimens, indicating a need for further education on febrile neutropenia risk evaluation and appropriate granulocyte colony-stimulating factor use.

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Section: Introductionmentioning

confidence: 99%

Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level

Baig

Somlo

Eisen

et al. 2018

J Oncol Pharm Pract

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Medication overuse in oncology: current trends and future implications for patients and society

Schleicher

Matsoukas

Korenstein

2018

The Lancet Oncology

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Summary: The high cost of cancer care worldwide is largely attributable to rising drugs prices. Despite their high costs and potential toxicities, anticancer treatments may be subject to overuse, defined as the provision of medical services that are more likely to harm than to benefit a patient. We found 30 studies documenting medication overuse in cancer, which included 16 examples of supportive medication overuse and 17 examples of anti-neoplastic medication overuse in oncology. Evaluated drugs were limited to relatively few specific agents, and no studies investigated overuse of the most toxic or expensive medications currently used in cancer treatment. While financial, psychological, or physical harms of medication overuse in cancer could be substantial, there is little literature addressing these harms so their magnitude is unclear. Further research is needed to better quantify rates of medication use, understand its implications, and help protect patients and the healthcare system from future overuse.

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Review of Cancer-Specific Quality Measures Promoting the Avoidance of Low-Value Care

et al. 2022

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Use, misuse, and overuse of white cell growth factors (GF) in community oncology practices in southeastern United States.

Cited by 3 publications

References 0 publications

Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level

Appropriateness of granulocyte colony-stimulating factor use in patients receiving chemotherapy by febrile neutropenia risk level

Medication overuse in oncology: current trends and future implications for patients and society

Review of Cancer-Specific Quality Measures Promoting the Avoidance of Low-Value Care

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