Pegfilgrastim for the prevention of chemotherapy-induced neutropenic complications, with dosing once per chemotherapy cycle
In the past 10 years, colony-stimulating factors (CSFs) such as filgrastim have been used successfully to reduce the clinical impact of chemotherapy-induced neutropenia. The recent availability of pegfilgrastim (Neulasta™), a next-generation pegylated filgrastim molecule with a sustained duration of action, is a significant advance in the management of chemotherapy-induced neutropenia. In contrast to repeated daily injections of filgrastim, pegfilgrastim is given only once per chemotherapy cycle in a single 6-mg fixed dose. Clinical data from two randomized trials demonstrated the equivalence of pegfilgrastim and filgrastim in reducing the duration of severe neutropenia following myelosuppressive chemotherapy. In addition, a retrospective analysis of both trials suggested an improved (approximately 50% greater) reduction in the overall incidence of febrile neutropenia with pegfilgrastim compared to filgrastim. A review of recent data on the cellular effects of CSFs provides insight into the possible mechanisms by which pegfilgrastim might produce this enhanced clinical benefit. The availability of pegfilgrastim, along with a greater understanding of the risk factors for neutropenic complications and their economic and quality-of-life consequences, offers simplified and possibly more cost-effective management of chemotherapy-induced neutropenia.
Duke Scholars
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Published In
ISSN
Publication Date
Volume
Issue
Start / End Page
Related Subject Headings
- Pharmacology & Pharmacy