A paper by Matti Aapro, MD, recently published in Supportive Cancer Care, outlined, for the first time, consensus recommendations on using pegfilgrastim in particular patients and therapeutic scenarios.
Chemotherapy-induced febrile neutropenia (FN), a side effect of many cancer treatments, can lead to infection, sepsis, and potentially death. Use of granulocyte-colony stimulating factor (G-CSF) agents, including the long-acting G-CSF pegfilgrastim, is recommended for both primary and secondary prophylaxis of chemotherapy-induced FN, and many providers and patients prefer pegfilgrastim to short-acting therapeutic options because of its less frequent administration.
A paper by Matti Aapro, MD, recently published in Supportive Cancer Care, outlined—for the first time—consensus recommendations on using pegfilgrastim in particular patients and therapeutic scenarios. The consensus recommendations were made by an advisory board convened in 2015; experts were selected to participate on the board if they were specialists in oncology or onco-hematology, had extensive clinical experience with short-acting and long-acting G-CSF agents, were fluent speakers of English, and were engaged in clinical research and academic work on chemotherapy-induced FN. Ahead of the panel’s meeting, a literature review was performed to establish the current evidence base on using pegfilgrastim.
The experts adopted the following recommendations and statements through consensus agreement:
On some topics—including whether pegfilgrastim or filgrastim is more appropriate in patients with bone pain, or what use of pegfilgrastim is most appropriate for patients with renal impairment—the panel was unable to reach a consensus.
The authors of the paper also note that biosimilar products are increasingly used for the prevention of FN; in both the United States and Europe, biosimilars of short-acting G-CSF agents are available. However, a biosimilar pegfilgrastim therapy has not yet received regulatory approval from either the FDA or the European Medicines Agency.