Empiric dose reduction of pegfilgrastim in breast cancer patients receiving cytotoxic chemotherapy

Safety and Efficacy of Pegfilgrastim When Given Less Than 14 Days Before the Next Chemotherapy Cycle: Review of Every 14-Day Chemotherapy Regimen Containing 5-FU Continuous Infusion

“…Whether or not a reduced dose of pegfilgrastim is as efficacious in preventing FN as a full dose of pegfilgrastim is controversial. [18][19][20] The results of the secondary end points further supported our primary end point findings. The mean ANC and WBC counts were statistically significantly higher with the Less-Than-14-Days-Group compared with the other 3 groups.…”

“…Whether or not a reduced dose of pegfilgrastim is as efficacious in preventing FN as a full dose of pegfilgrastim is controversial. 18-20…”

Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

“…One retrospective chart review demonstrated that a dose reduction to 4 mg resulted in a decreased incidence of PIBP without an increased risk for treatment delay or FN. 23 A retrospective analysis of several preapproval clinical trials evaluating pegfilgrastim found that administration of 3 mg of pegfilgrastim did not reduce the incidence of PIBP when compared with patients receiving 6 mg. 24 Also, patients receiving the lower dose of pegfilgrastim had a higher incidence of FN following the first cycle of chemotherapy compared with patients receiving the standard dose of pegfilgrastim. Given these mixed results and the potential for increased risk of developing FN, dose reduction of pegfilgrastim should be done very cautiously.…”

“…Paba et al 23 conducted a retrospective chart review of 25 patients with breast cancer who received pegfilgrastim support with their adjuvant or neoadjuvant chemotherapy. The patients reviewed had their pegfilgrastim doses empirically reduced from 6 to 4 mg as a result of bone pain.…”

Pegfilgrastim use and bone pain: a cohort study of community-based cancer patients

“…10 Alternatively, G-CSF dose reductions have been considered to reduce bone pain, but data describing its efficacy are limited. 16,17 Therefore, that practice is not currently recommended. Overall, effective therapies to prevent or treat pegfilgrastim-induced bone pain have yet to be identified and are greatly needed.…”