Data from a recent study show that biosimilar filgrastim is readily used in France for the prophylaxis of chemotherapy-induced neutropenia. The data also demonstrate that clinicians’ assessment of febrile neutropenia risk is driven by patient factors more than by the European Organisation for the Research and Treatment of Cancer’s risk category of the chemotherapy regimen.
Data from a recent study show that biosimilar filgrastim is readily used in France for the prophylaxis of chemotherapy-induced neutropenia. The data also demonstrate that clinicians’ assessment of febrile neutropenia (FN) risk is driven by patient factors more than by the European Organisation for the Research and Treatment of Cancer’s (EORTC) risk category of the chemotherapy regimen.
A filgrastim biosimilar with demonstrated equivalence in clinical safety and efficacy to the reference filgrastim (Novartis’ Neupogen), Zarzio is mostly used as primary prophylaxis for chemotherapy-induced neutropenia in patients with solid tumors or hematological malignancies (HM). Data from the ZOHé study on Zarzio, sponsored by Sandoz, were reported in the June 2017 issue of Clinical Lymphoma, Myeloma & Leukemia.
The prospective, observational, multicenter study was conducted between June 2013 and April 2014 across 125 sites in France in order to assess the use of biosimilar filgrastim Zarzio in adults undergoing chemotherapy for either solid tumors (1174 patients) or a HM (633 patients). The present publication reports only the results for the use of Zarzio in patients with hematologic malignancy who had a first prescription for the biosimilar filgrastim.
The biosimilar filgrastim was administered for a median of 4 cycles of chemotherapy across the cohort. Treatment stayed constant in subsequent cycles for 89.6% of patients; among the 10.4% of patients who had treatment modifications, most changes were to treatment duration. Overall, 28.6% of patients stopped receiving biosimilar filgrastim before the end of the study, mostly due to cessation of chemotherapy; 8 patients stopped treatment because of adverse events linked to the drug.
All treatment guidelines recommend granulocyte colony-stimulating factor (G-CSF) prophylaxis where a risk of FN due to chemotherapy is greater than or equal to 20%, and for patients with intermediate risk (10% to 20%) who have additional risk factors (eg, 65 years or older, advanced stage of disease, previous episodes of FN, low performance status, and comorbidities). In the study, most patients had 2 or more EORTC patient-related risk factors for FN. Chemotherapy dose intensity was maintained in 85.2% of evaluable patients and 89.6% of patients with non-Hodgkin lymphoma receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone. A total of 53 adverse events (AEs) associated with Zarzio occurred in 4.9% of all patients. None of the AEs were reported as being serious.
The study’s results suggest that, in real-world practice, clinicians predominantly give biosimilar filgrastim to patients whom they consider to be at high risk of FN, either due to their chemotherapy regimen, a combination of risk factors due to patient characteristics, or both. “However, many of the chemotherapy regimens used in clinical practice do not have an FN risk category in the guidelines,” the authors point out. With these patients, clinicians must rely on patient-related risk factors to guide their decision to prescribe G-CSF support.
“Most patients in the HM cohort of ZOHé had 2 to 3 patient-based risk factors for increased incidence of FN, which along with the ≥10% FN risk intrinsic to HM, most likely underlies the clinicians’ decision to prescribe primary prophylaxis,” they said. “The need for G-CSF support to maintain dose intensity in patients with HM who are given chemotherapy with curative intent could also underlie clinicians’ use of Zarzio.”
What Clinicians Need to Know About Using Biosimilars to Treat IBD
April 13th 2024A review article, intended to act as a guide for clinicians, summarizes the available infliximab and adalimumab biosimilars for treating inflammatory bowel disease (IBD) as well as others that are coming down the pipeline.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
Study: More Biosimilar Competition Is Not Lowering Patient OOP Costs
March 29th 2024Despite more biosimilars entering the market and generating significant savings for payers and health care systems, these savings are not resulting in lower out-of-pocket (OOP) costs for patients, according to a recent study.
Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars
April 16th 2023What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.
The Role of Biosimilars: Advancing Access, Financial Health, and System Sustainability
March 11th 2024Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, a member of the Community Oncology Alliance, and member of The Center for Biosimilars® Advisory Board, glances back at the development of the biosimilar industry and the last 5 years of progress.