Retrospective evaluation of safety and effectiveness of same-day pegfilgrastim in patients with lung cancer

Future Oncol. 2022 Jun;18(19):2381-2390. doi: 10.2217/fon-2022-0166. Epub 2022 Apr 28.

Abstract

Aim: To determine the incidence of chemotherapy-induced febrile neutropenia (FN) and related outcomes after same-day pegfilgrastim in lung cancer. Materials & methods: This single-center, retrospective study evaluated electronic health records of patients with lung cancer treated between 2013-2018. The main end points were incidence of FN and grade 3/4 neutropenia after the first and across all chemotherapy cycles. Results: A total of 114 patients received same-day pegfilgrastim in 384 cycles. The incidence of FN and grade 3/4 neutropenia was 2.3 and 25% after the first chemotherapy cycle and 1.6 and 10.4% across all cycles, respectively. Conclusion: Same-day prophylactic pegfilgrastim in patients with lung cancer may be a suitable option, owing to its low incidence of FN and related outcomes.

Keywords: NSCLC; SCLC; febrile neutropenia; lung cancer; neutropenia; same-day pegfilgrastim.

Plain language summary

Chemotherapy is intended to kill fast-growing cancer cells but can also kill immune cells that are needed to prevent infections. When too many immune cells are killed by chemotherapy, patients with cancer may experience febrile neutropenia, a serious condition that can lead to death in the most severe cases. To prevent this side effect of chemotherapy, a protein that helps certain immune cells to grow (pegfilgrastim) is administered on the day after chemotherapy. To avoid a second clinic visit the day after receiving chemotherapy, it has become common to administer pegfilgrastim on the same day as chemotherapy. Whether this approach is as effective and safe as next-day administration is currently unclear. This study from the University of Arizona Cancer Center showed that in patients with lung cancer who receive chemotherapy, administration of pegfilgrastim on the same day as chemotherapy is a safe, effective method to prevent febrile neutropenia.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Chemotherapy-Induced Febrile Neutropenia* / epidemiology
  • Chemotherapy-Induced Febrile Neutropenia* / etiology
  • Chemotherapy-Induced Febrile Neutropenia* / prevention & control
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Humans
  • Leukopenia* / chemically induced
  • Lung Neoplasms* / complications
  • Lung Neoplasms* / drug therapy
  • Polyethylene Glycols
  • Recombinant Proteins / adverse effects
  • Retrospective Studies

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Filgrastim