Pegfilgrastim for the prevention of chemotherapy-induced febrile neutropenia in patients with solid tumors.
BACKGROUND
Neutropenia and febrile neutropenia are the most common and most severe bone marrow toxicities of chemotherapy. Recombinant granulocyte-colony stimulating factors (G-CSFs), both daily (filgrastim and biosimilars, and lenograstim) and long-acting (pegfilgrastim and lipegfilgrastim) formulations, are currently available to counteract the negative consequences of these side effects.


METHODS
The purpose of this article is to review the physiopathology of chemotherapy-induced febrile neutropenia and its consequences, and the current evidence regarding the pharmacological properties, clinical efficacy and cost-effectiveness of pegfilgrastim as a strategy to prevent chemotherapy-induced febrile neutropenia in patients with solid tumors.


CONCLUSIONS
Chemotherapy-induced febrile neutropenia and its complications are still a major health-care concern, and the inappropriate employment of G-CSFs in clinical practice can partially explain its burden. Pegfilgrastim has pharmacological advantages over daily G-CSFs that makes it easily administrable, thus reducing the chance of incorrect delivery. The once-per-cycle administration might explain the findings derived from observational studies suggesting a possible superior efficacy of pegfilgrastim over daily G-CSFs. For patients at higher risk of failure with daily G-CSF prophylaxis (e.g. risk of non-compliance, difficulties on performing regular hemograms, high risk of developing febrile neutropenia), pegfilgrastim might be the most appropriate option.
a Department of Medical Oncology, U.O. Oncologia Medica 2 , IRCCS AOU San Martino - IST , 16132 Genoa , Italy.
Matteo
M
Lambertini
b Department of Medical Oncology , Hospital de Santa Maria and Instituto de Medicina Molecular of the Faculty of Medicine of the University of Lisbon , 1600 Lisbon , Portugal.
Arlindo R
AR
Ferreira
c Department of Medical Oncology , U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino - IST , 16132 Genoa , Italy.
Lucia
L
Del Mastro
d Department of Clinical and Experimental Medicine , University of Pisa , 56126 Pisa , Italy.
Romano
R
Danesi
a Department of Medical Oncology, U.O. Oncologia Medica 2 , IRCCS AOU San Martino - IST , 16132 Genoa , Italy.
Paolo
P
Pronzato
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D059451:Biosimilar Pharmaceuticals / Q000627:therapeutic use; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control*; D000069585:Filgrastim / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods; D000078224:Lenograstim; D009369:Neoplasms / Q000188:drug therapy* / Q000276:immunology; D011092:Polyethylene Glycols; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D011994:Recombinant Proteins / Q000627:therapeutic use
D000970:Antineoplastic Agents; D059451:Biosimilar Pharmaceuticals; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000078224:Lenograstim; D000069585:Filgrastim
chemotherapy-induced febrile neutropenia; long-acting G-CSF; pegfilgrastim; solid tumors