title: A randomized double-blind multicenter phase III study of fixed-dose single-administration pegfilgrastim versus daily filgrastim in patients receiving myelosuppressive chemotherapy.
abstract: BACKGROUND
  We evaluated the efficacy of a single fixed 6 mg dose of pegfilgrastim (a pegylated version of filgrastim) per cycle of chemotherapy, compared with daily administration of filgrastim, in the provision of neutrophil support.
  
  
  METHODS
  Patients (n = 157) were randomized to receive either a single 6 mg subcutaneous (s.c.) injection of pegfilgrastim or daily 5 mg/kg s.c. injections of filgrastim, after doxorubicin and docetaxel chemotherapy (60 mg/m(2) and 75 mg/m(2), respectively). Duration of grade 4 neutropenia, depth of neutrophil nadir, incidence of febrile neutropenia, time to neutrophil recovery and safety information were recorded.
  
  
  RESULTS
  A single 6 mg injection of pegfilgrastim was as effective as daily injections of filgrastim for all efficacy measures for all cycles. The mean duration of grade 4 neutropenia in cycle 1 was 1.8 and 1.6 days for the pegfilgrastim and filgrastim groups, respectively. Results for all efficacy end points in cycles 2-4 were consistent with the results from cycle 1. A trend towards a lower incidence of febrile neutropenia was noted across all cycles with pegfilgrastim compared with filgrastim (13% versus 20%, respectively). A single fixed dose of pegfilgrastim was as safe and well tolerated as standard daily filgrastim.
  
  
  CONCLUSIONS
  A single fixed dose of pegfilgrastim administered once per cycle of chemotherapy was comparable to multiple daily injections of filgrastim in safely providing neutrophil support during myelosuppressive chemotherapy. Pegfilgrastim may have utility in other clinical settings of neutropenia.
authors.affiliation: Royal Melbourne Hospital, Melbourne, Australia. michael.green@mh.org.au
authors.forename: M D
authors.initials: MD
authors.lastname: Green
authors.forename: H
authors.initials: H
authors.lastname: Koelbl
authors.forename: J
authors.initials: J
authors.lastname: Baselga
authors.forename: A
authors.initials: A
authors.lastname: Galid
authors.forename: V
authors.initials: V
authors.lastname: Guillem
authors.forename: P
authors.initials: P
authors.lastname: Gascon
authors.forename: S
authors.initials: S
authors.lastname: Siena
authors.forename: R I
authors.initials: RI
authors.lastname: Lalisang
authors.forename: H
authors.initials: H
authors.lastname: Samonigg
authors.forename: M R
authors.initials: MR
authors.lastname: Clemens
authors.forename: V
authors.initials: V
authors.lastname: Zani
authors.forename: B C
authors.initials: BC
authors.lastname: Liang
authors.forename: J
authors.initials: J
authors.lastname: Renwick
authors.forename: M J
authors.initials: MJ
authors.lastname: Piccart
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003692:Delayed-Action Preparations; D000077143:Docetaxel; D004311:Double-Blind Method; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000031:analogs & derivatives; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy*; D009504:Neutrophils / Q000502:physiology; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D043823:Taxoids
chemical_list: D003692:Delayed-Action Preparations; D011994:Recombinant Proteins; D043823:Taxoids; D016179:Granulocyte Colony-Stimulating Factor; D000077143:Docetaxel; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D004317:Doxorubicin; D017239:Paclitaxel; D000069585:Filgrastim