Efficacy and safety analysis of once per cycle pegfilgrastim and daily lenograstim in patients with breast cancer receiving adjuvant myelosuppressive chemotherapy FEC 100: a pilot study

Abstract

BackgroundNeutropenia is a common toxicity in patients receiving myelosuppressive chemotherapy. In this prospective pilot study, we compared the efficacy and safety profiles of pegfilgrastim administered subcutaneously once per cycle and lenograstim administered subcutaneously daily six times per cycle, for primary neutropenia prophylaxis in women with breast cancer receiving adjuvant anthracycline-based chemotherapy.Materials and methodsTwenty women were enrolled. All patients received epirubicin 100 mg/m2 with 5-fluorouracil 500 mg/m2 and cyclophosphamide 500 mg/m2 on day 1 and every 21 days thereafter, according to the FEC 100 chemotherapy regimen. Eight patients received a single dose of pegfilgrastim on day 2, while 12 patients were treated with daily administration of lenograstim from days five to ten. Absolute neutrophil count and duration of grade 3–4 neutropenia were monitored using seriated blood samples. The incidence of bone pain was evaluated using the visual analog scale (VAS).ResultsThe incidence of grade 3–4 neutropenia was 75% in patients who received pegfilgrastim, and 25% in patients who received lenograstim. One case of febrile neutropenia was shown in pegfilgrastim patients. The mean duration of grade 3–4 neutropenia was 2 days in pegfilgrastim group versus 1.4 days in the lenograstim group. Bone pain was present in 37.5% of pegfilgrastim patients versus 58.3% of lenograstim patients. The mean duration of bone pain in the pegfilgrastim group was 4 days versus 6 days in the lenograstim group.ConclusionIn our experience, a single injection of pegfilgrastim was less effective for controlling neutropenia than six daily injections of lenograstim. The safety profiles of pegfilgrastim and lenograstim were similar with a lower incidence of bone pain in patients treated with pegfilgrastim.

Efficacy, safety and proper dose analysis of PEGylated granulocyte colony-stimulating factor as support for dose-dense adjuvant chemotherapy in node positive Chinese breast cancer patients

“…Compared to short-acting G-CSF, the long-acting PEG-G-CSF exhibits advantages not only in preventive and curative effects, but also in side effects, convenience and patients’ living quality. Although PEG-G-CSF is equal to short-acting G-CSF in terms of the incidence rates of fever, debility, and pains in bone, joins and muscle, administration of PEG-G-CSF can markedly reduce the morbidity of FN-induced infection or other complications [ 9 , 21 ]. Additionally, benefiting from extended half-life, PEG-G-CSF can significantly reduce the times of repetitive injections, improve the quality of life, and reduce the comprehensive costs related to FN therapy [ 22 ].…”

Efficacy and tolerability of granulocyte colony-stimulating factors in cancer patients after chemotherapy: A systematic review and Bayesian network meta-analysis

“…Febrile neutropenia (FN) and severe neutropenia (SN) are the most common and serious complications of cancer patients after treatment with cytotoxic chemotherapy 1 . These complications lead to chemotherapy delay, dose reduction, and increased risk of infection 2 . Patients with these complications need to be treated with antibiotics and hospitalization 3 , which indirectly increases the cost for care of these patients 4 .…”

Efficacy, effectiveness and safety of long-acting granulocyte colony-stimulating factors for prophylaxis of chemotherapy-induced neutropenia in patients with cancer: a systematic review

“…Patients experiencing neutropenic events are more susceptible to subsequent infections [2]. As a consequence of FN, patients often require hospitalisation and antibiotic treatment and frequently have their chemotherapy dose reduced or delayed [3,4]. Modifications to chemotherapy may decrease its effectiveness, thereby potentially compromising treatment outcomes [4].…”