Safety of G-CSF with concurrent chemo-radiotherapy in limited-stage small cell lung cancer - Secondary analysis of the randomised phase 3 CONVERT trial

Gomes, Fábio; Faivre-Finn, Corinne; Mistry, Hitesh; Bezjak, Andrea; Pourel, N.; Fournel, P.; Meerbeeck, Jan Van; Blackhall, Fiona

doi:10.1016/j.lungcan.2021.01.025

Cited by 13 publications

(7 citation statements)

References 15 publications

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“…Therefore, the reduction in the PLT count may be a manifestation of myelosuppression and not closely related to PEG-rhG-CSF administration. CONVERT is a phase III randomized controlled trial involving 547 patients with SCLC treated with CCRT [ 6 ]. Of the patients, 33% received at least one cycle of prophylactic G-CSF, and 41% received therapeutic G-CSF.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the NCCN guidelines removed the non-recommendation for G-CSF prophylaxis during CCRT. In addition, modern precision radiotherapy techniques can significantly reduce toxic effects compared with previous two-dimensional techniques, an d some data from relevant clinical trials show that G-CSF combined with radiotherapy and chemotherapy does not increase chest toxicity and has no effect on survival [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor during concurrent chemoradiotherapy for small-cell lung cancer: a retrospective, cohort-controlled trial

et al. 2022

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Objective To investigate pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) safety and efficacy in preventing hematological toxicity during concurrent chemoradiotherapy (CCRT) for small-cell lung cancer (SCLC). Methods We retrospectively assessed 80 SCLC patients treated with CCRT from January 2013 to December 2018 who received PEG-rhG-CSF within 48 hours after the end of chemotherapy, defined as prophylactic use, as the experimental group. An additional 80 patients who were not treated with PEG-rhG-CSF were matched 1:1 by the propensity score matching method and served as the control group. The main observations were differences in hematological toxicity, neutrophil changes, febrile neutropenia (FN) incidence and adverse reactions. Progression-free survival (PFS) and overall survival (OS) were analyzed with regular assessment and follow-up. Results The leukocyte, neutrophil, erythrocyte, and platelet counts and hemoglobin level decreased after CCRT, but the experimental group had slightly higher leukocyte and neutrophil counts than the control group (P < 0.05). The incidences of grade III-IV leukopenia (18.75% vs. 61.25%) and neutropenia (23.75% vs. 67.5%) in the experimental group were significantly lower than those in the control group (P < 0.05). The absolute neutrophil count was 4.17 ± 0.79 (× 109/L) on day 1 and peaked 6.81 ± 2.37 (× 109/L) on day 10 in the experimental group; the value in the control group was 2.81 ± 0.86 (× 109/L) on day 1. It decreased significantly and reached the minimum 0.91 ± 0.53 (× 109/L) on day 10 (P < 0.05). The experimental group had a lower FN incidence than the control group (P < 0.05). There was also no significant acute esophagitis or pulmonary toxicity. The treatment had no significant effect on PFS (11.4 months vs. 8.7 months, P = 0.958) or OS (23.9 months vs. 17.3 months, P = 0.325) over an 18.6-month median follow-up time. Conclusion PEG-rhG-CSF has good efficacy and safety in preventing hematological toxicity in SCLC patients during CCRT and has no significant effects on PFS or OS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor during concurrent chemoradiotherapy for small-cell lung cancer: a retrospective, cohort-controlled trial

et al. 2022

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“…Moreover, no significant differences were observed in radiation‐related toxicity, treatment‐related mortality rates, or survival outcomes. Based on the results of the CONVERT study, the National Comprehensive Cancer Network (NCCN) clinical practice guidelines for hematopoietic growth factors (version 1.0, 2023) recommend that G‐CSF should be administered with caution during CCRT 8,32 . In addition, the Chinese Society of Clinical Oncology (CSCO) Guidelines for the Standardized Management of Oncology Radiotherapy‐Induced Neutropenia (version 2021) recommend the use of G‐CSF for the prevention and treatment of CCRT‐induced neutropenia and FN, with reference to the principles of primary and secondary prophylaxis of chemotherapy‐induced neutropenia, under the close monitoring of the patient's hematological indicators 33…”

Section: Efficacy and Safety Of Peg‐rhg‐csf During Ccrtmentioning

confidence: 99%

Chinese expert consensus on the application of pegylated recombinant human granulocyte colony‐stimulating factor during concurrent chemoradiotherapy (2023 edition)

Wang,

2023

Precision Radiation Oncology

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Neutropenia is the most common hematological toxicity of concurrent chemoradiotherapy (CCRT), and leads to subsequent treatment delays and/or dose reductions. Neutropenia often advances to febrile neutropenia and serious infections, which can affect the prognosis and safety of patients. The reasonable prevention and management of neutropenia is vital for patients with malignancies undergoing CCRT. Pegylated recombinant human granulocyte colony‐stimulating factor (PEG‐rhG‐CSF), a long‐acting recombinant human granulocyte colony‐stimulating factor, can prevent and treat neutropenia in more convenient clinical settings. Based on relevant guidelines and the most recent clinical data, the Chinese Association for Therapeutic Radiation Oncologists, China Society for Radiation Oncology, and Chinese Association of Radiation Therapy have evaluated the safety and efficacy of PEG‐rhG‐CSF during CCRT, clearly defined the clinical pathway and route of administration for the prevention and treatment of neutropenia, and formed a Chinese expert consensus on PEG‐rhG‐CSF application during CCRT, with the goal of promoting the reasonable clinical use of this treatment.

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“…It is also interesting to note a higher-dose intensity of cisplatin with G-CSF prophylaxis. It is possible that the higher-dose intensity increases the rate of thrombocytopenia and anemia in patients with already reduced bone marrow reserve [86]. G-CSF prophylaxis for radiation chemotherapy could therefore be justified with these new findings [87].…”

Section: G-csf and Radiation Therapymentioning

confidence: 99%

Current state and future opportunities in granulocyte colony-stimulating factor (G-CSF)

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2022

Support Care Cancer

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Safety of G-CSF with concurrent chemo-radiotherapy in limited-stage small cell lung cancer - Secondary analysis of the randomised phase 3 CONVERT trial

Cited by 13 publications

References 15 publications

Safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor during concurrent chemoradiotherapy for small-cell lung cancer: a retrospective, cohort-controlled trial

Safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor during concurrent chemoradiotherapy for small-cell lung cancer: a retrospective, cohort-controlled trial

Chinese expert consensus on the application of pegylated recombinant human granulocyte colony‐stimulating factor during concurrent chemoradiotherapy (2023 edition)

Current state and future opportunities in granulocyte colony-stimulating factor (G-CSF)

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