Use of G-CSF during concurrent chemotherapy and thoracic radiotherapy in patients with limited-stage small-cell lung cancer safety data from a phase II trial

Sheikh, Hamid Y; Colaco, Rovel; Lorigan, Paul; Blackhall, Fiona; Califano, Raffaele; Ashcroft, Linda; Taylor, Paul D.; Thatcher, Nick; Faivre-Finn, Corinne

doi:10.1016/j.lungcan.2011.01.020

Cited by 18 publications

(16 citation statements)

References 21 publications

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“…The use of G-CSF in CRT is still controversial and most recent recommendations on its use derive from studies in chest malignancies. [ 24 , 25 ] Even if neutropenia is reversed, old reports for abdominal RT and extended field CRT in chest malignancies stated a small number patients had severe thrombocytopenia with the use of G-CSF. [ 26 ] This led ASCO to recommend against use of CSFs for CRT, but these recommendations are being questioned.…”

Section: Discussionmentioning

confidence: 99%

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Chemoradiotherapy completion and neutropenia risk in HIV patients with cervical cancer

et al. 2018

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Cervical cancer (CC) is one of the acquired immunodeficiency syndrome (AIDS) defining diseases and the human immunodeficiency virus (HIV) infection is thought to relate with increased acute toxicity of chemoradiotherapy (CRT).We investigated the effect of HIV status in the incidence of neutropenia associated with cisplatin-based CRT for CC and its impact in treatment completion.This is a single-center retrospective cohort study. Data collection was performed for all the consecutive stage Ib-IV CC women treated with cisplatin-based CRT from 2012 to 2016, and with known HIV status.Sixty-one patients were included, 6 were HIV+. HIV+ patients had a higher risk of neutropenia at any cycle during cisplatin CRT [adjusted odds ratio (OR) 7.3, 95% confidence interval (95% CI) 1.02–52.3; P = .05]. Despite the absolute differences, mean neutrophil count was nonsignificantly lower in HIV+ women, both at baseline [4455/μL (interquartile range, IQR: 1830–6689) vs 6340 (IQR: 1720–18,970) for HIV−, P = .98] and at the end of treatment [1752/μL (IQR: 1100–2930) vs 3147/μL (IQR: 920–18,390) in HIV−; P = .06]. Moreover, when considering the effect of time, CRT seems to induce a consistent drop of neutrophils in both groups (P = .229). No febrile neutropenia events occurred.In HIV+ women, there were more CT cycle delays (P = .013), patients were more prone to use granulocyte colony-stimulating factor (G-CSF; HIV+ 40.0% vs HIV− 4.0%; P = .04) and less likely to complete at least 5 cycles of cisplatin (P = .02). All patients received adequate dose of pelvic RT, regardless of HIV status.HIV+ patients have a significantly increased risk of neutropenia during CRT treatment for CC and are less likely to complete chemotherapy with cisplatin.

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Section: Discussionmentioning

confidence: 99%

“…[ 26 ] This led ASCO to recommend against use of CSFs for CRT, but these recommendations are being questioned. [ 24 , 27 ]…”

Section: Discussionmentioning

confidence: 99%

Chemoradiotherapy completion and neutropenia risk in HIV patients with cervical cancer

et al. 2018

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“…It will be of interest to test FSL–1 in cancer models for determining its potential application in cancer therapy. There is substantial research demonstrating the benefits of G–CSF in protecting individuals from adverse effects, including insults to the hematopoietic system associated with radio– or chemotherapies 41 , 42 . Specifically, G–CSF contributes to the mobilization of hematopoietic cells in cancer patients undergoing various treatments 43 .…”

Section: Discussionmentioning

confidence: 99%

The Toll–Like Receptor 2/6 Agonist, FSL–1 Lipopeptide, Therapeutically Mitigates Acute Radiation Syndrome

Kurkjian

Guo

Montgomery

et al. 2017

Sci Rep

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Risks of radiation exposure from nuclear incidents and cancer radiotherapy are undeniable realities. These dangers urgently compel the development of agents for ameliorating radiation–induced injuries. Biologic pathways mediated by myeloid differentiation primary response gene 88 (MyD88), the common adaptor for toll–like receptor (TLR) and Interleukin–1 receptor signaling, are critical for radioprotection. Treating with agonists prior to radiation enhances survival by activating TLR signaling, whereas radiomitigating TLR–activating therapeutics given after exposure are less defined. We examine the radiomitigation capability of TLR agonists and identify one that is superior for its efficacy and reduced toxic consequences compared to other tested agonists. We demonstrate that the synthetic TLR2/6 ligand Fibroblast–stimulating lipopeptide (FSL–1) substantially prolongs survival in both male and female mice when administered 24 hours after radiation and shows MyD88–dependent function. FSL–1 treatment results in accelerated hematopoiesis in bone marrow, spleen and periphery, and augments systemic levels of hematopoiesis–stimulating factors. The ability of FSL–1 to stimulate hematopoiesis is critical, as hematopoietic dysfunction results from a range of ionizing radiation doses. The efficacy of a single FSL–1 dose for alleviating radiation injury while protecting against adverse effects reveals a viable radiation countermeasures agent.

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“…In clinical practice, in weekly regimens rG-CSF is administered in order to avoid delay of CT on day 8 owing to neutropenia. For example, in weekly CT/radiotherapy regimens administered in patients with head and neck tumors, 11-20% of patients need modifications to planned treatment because of neutropenia [70,71].…”

Section: Weekly Regimensmentioning

confidence: 99%

Optimal use of recombinant granulocyte colony-stimulating factor with chemotherapy for solid tumors

Danova¹,

Barni

Mastro³

et al. 2011

Expert Review of Anticancer Therapy

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Neutropenia is a frequent complication of anticancer chemotherapy (CT) often associated with life-threatening infections, hospitalization, dose reduction and/or delay in the administration of CT. Administration of recombinant granulocyte colony-stimulating factor (rG-CSF) reduces the duration and the degree of CT-neutropenia. rG-CSF that stimulates both neutropoiesis and neutrophil function, has become an integral part of supportive care during cytotoxic CT, to prevent febrile neutropenia (FN), particularly in patients with a risk of FN ≥ 20%. International guidelines have standardized conditions for rG-CSF administration, however, some 'gray zones' still exist around optimal timing and tailoring of this therapy. We report here the results of a research project aimed to extend the consensus on the optimal use of rG-CSF in association with CT in patient with solid tumours. We also propose a recently developed pharmacodynamic model, based on the biological effects of CT and rG -CSF on bone marrow compartments that clearly indicates within the prophylactic rather than therapeutic setting the better way of rG-CSF administration.

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Use of G-CSF during concurrent chemotherapy and thoracic radiotherapy in patients with limited-stage small-cell lung cancer safety data from a phase II trial

Cited by 18 publications

References 21 publications

Chemoradiotherapy completion and neutropenia risk in HIV patients with cervical cancer

Chemoradiotherapy completion and neutropenia risk in HIV patients with cervical cancer

The Toll–Like Receptor 2/6 Agonist, FSL–1 Lipopeptide, Therapeutically Mitigates Acute Radiation Syndrome

Optimal use of recombinant granulocyte colony-stimulating factor with chemotherapy for solid tumors

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