title: Prophylactic long-acting granulocyte-colony stimulating factors (G-CSF) in gynecologic malignancies: an oncologic expert statement.
abstract: We reviewed the status of the use of the prophylactic long-acting granulocyte colony-stimulating factors (G-CSFs) pegfilgrastim and lipegfilgrastim in gynecologic malignancies. Long-acting G-CSFs should not be used in weekly regimens. Filgrastim is not indicated in patients with febrile and/or severe neutropenia after administration of long-acting G-CSF in the same cycle. One study has shown a moderate effect on febrile neutropenia of ciprofloxacin when co-administered with pegfilgrastim. There is broad evidence from meta-analyses that pegfilgrastim effectively reduces severe neutropenia. In parallel, its adverse effects have been studied extensively. All-cause mortality was significantly reduced by pegfilgrastim. The glycopegylated long-acting G-CSF, lipegfilgrastim has demonstrated antineutropenic efficacy similar to that of pegfilgrastimin in one breast cancer study. In another pivitol non-small cell lung cancer study, impaired survival was observed in the lipegfilgrastim group during the first 30 days of study. The European Medicines Agency claimed more profound safety data to be provided for lipegfilgrastim by 2017.
authors.affiliation: Division of Gynecology, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria. edgar.petru@medunigraz.at.
authors.forename: Edgar
authors.initials: E
authors.lastname: Petru
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian F
authors.initials: CF
authors.lastname: Singer
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
authors.affiliation: Department of Obstetrics and Gynecology, Hanuschkrankenhaus, Vienna, Austria.
authors.forename: Arik
authors.initials: A
authors.lastname: Galid
authors.affiliation: Department of Gynecology, Hospital Barmherzige Brüder Graz, Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Schauer
authors.affiliation: Department of Internal Medicine, Klinikum Klagenfurt, Klagenfurt, Austria.
authors.forename: Johann
authors.initials: J
authors.lastname: Klocker
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Seifert
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
authors.affiliation: Division of Gynecology, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Benedicic
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Hubalek
authors.affiliation: Department of Gynecology, Hospital Barmherzige Schwestern, Linz, Austria.
authors.forename: Lukas
authors.initials: L
authors.lastname: Hefler
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
authors.affiliation: Department of Obstetrics and Gynecology, Wilhelminenspital, Vienna, Austria.
authors.forename: Tonja
authors.initials: T
authors.lastname: Scholl-Firon
authors.affiliation: Department of Obstetrics and Gynecology, Paracelsus University of Salzburg, Salzburg, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bogner
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Alain-Gustave
authors.initials: AG
authors.lastname: Zeimet
mesh_terms: D002423:Cause of Death; D002939:Ciprofloxacin / Q000627:therapeutic use; D000075202:Contraindications; D003692:Delayed-Action Preparations; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D000069585:Filgrastim; D005833:Genital Neoplasms, Female / Q000188:drug therapy* / Q000401:mortality; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy / Q000401:mortality; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D016019:Survival Analysis
chemical_list: D003692:Delayed-Action Preparations; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D002939:Ciprofloxacin; D000069585:Filgrastim
keywords: Chemotherapy-induced neutropenia; Febrile neutropenia; Granulocyte colony-stimulating factors (G-CSF); Gynecologic cancer; Long-acting granulocyte colony stimulating factors