Pegfilgrastim: evidence in support of its use with cytotoxic chemotherapy.
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.
Ng
Raymond
R
Department of Haemotology and Medical Oncology, Royal Melbourne Hospital, Australia.
Green
Michael D
MD
D000208:Acute Disease; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D002986:Clinical Trials as Topic; D017850:Economics, Pharmaceutical; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000191:economics / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy; D008223:Lymphoma / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced* / Q000188:drug therapy*; D011092:Polyethylene Glycols; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins
D000970:Antineoplastic Agents; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim