title: Optimal use of recombinant granulocyte colony-stimulating factor with chemotherapy for solid tumors.
abstract: Neutropenia is a frequent complication of anticancer chemotherapy (CT) often associated with life-threatening infections, hospitalization, dose reduction and/or delay in the administration of CT. Administration of recombinant granulocyte colony-stimulating factor (rG-CSF) reduces the duration and the degree of CT-neutropenia. rG-CSF that stimulates both neutropoiesis and neutrophil function, has become an integral part of supportive care during cytotoxic CT, to prevent febrile neutropenia (FN), particularly in patients with a risk of FN ≥ 20%. International guidelines have standardized conditions for rG-CSF administration, however, some 'gray zones' still exist around optimal timing and tailoring of this therapy. We report here the results of a research project aimed to extend the consensus on the optimal use of rG-CSF in association with CT in patient with solid tumours. We also propose a recently developed pharmacodynamic model, based on the biological effects of CT and rG -CSF on bone marrow compartments that clearly indicates within the prophylactic rather than therapeutic setting the better way of rG-CSF administration.
authors.affiliation: SC Medicina Interna e Oncologia Medica, Azienda Ospedaliera di Pavia, Ospedale Civile di Vigevano, Corso Milano, 19-27029, Vigevano (Pavia), Italy. onco.vigevano@gmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Danova
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
authors.forename: Lucia
authors.initials: L
authors.lastname: Del Mastro
authors.forename: Romano
authors.initials: R
authors.lastname: Danesi
authors.forename: Giovanni L
authors.initials: GL
authors.lastname: Pappagallo
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor