Pegfilgrastim for the prevention of chemotherapy-induced febrile neutropenia in patients with solid tumors

Matteo Lambertini, Arlindo R. Ferreira, Lucia Del Mastro, Romano Danesi, Paolo Pronzato

Research output: Contribution to journalArticle

Abstract

Introduction: Neutropenia and febrile neutropenia are the most common and most severe bone marrow toxicities of chemotherapy. Recombinant granulocyte-colony stimulating factors (G-CSFs), both daily (filgrastim and biosimilars, and lenograstim) and long-acting (pegfilgrastim and lipegfilgrastim) formulations, are currently available to counteract the negative consequences of these side effects. Areas covered: The purpose of this article is to review the physiopathology of chemotherapy-induced febrile neutropenia and its consequences, and the current evidence regarding the pharmacological properties, clinical efficacy and cost-effectiveness of pegfilgrastim as a strategy to prevent chemotherapy-induced febrile neutropenia in patients with solid tumors. Expert opinion: Chemotherapy-induced febrile neutropenia and its complications are still a major health-care concern, and the inappropriate employment of G-CSFs in clinical practice can partially explain its burden. Pegfilgrastim has pharmacological advantages over daily G-CSFs that makes it easily administrable, thus reducing the chance of incorrect delivery. The once-per-cycle administration might explain the findings derived from observational studies suggesting a possible superior efficacy of pegfilgrastim over daily G-CSFs. For patients at higher risk of failure with daily G-CSF prophylaxis (e.g. risk of non-compliance, difficulties on performing regular hemograms, high risk of developing febrile neutropenia), pegfilgrastim might be the most appropriate option.

Original languageEnglish
JournalExpert Opinion on Biological Therapy
DOIs
Publication statusAccepted/In press - Oct 22 2015

Keywords

  • chemotherapy-induced febrile neutropenia
  • long-acting G-CSF
  • pegfilgrastim
  • solid tumors

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Biochemistry
  • Drug Discovery

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