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Wien Med Wochenschr. 2015 Oct;165(19-20):387-94. doi: 10.1007/s10354-015-0392-3. Epub 2015 Oct 15.

Prophylactic long-acting granulocyte-colony stimulating factors (G-CSF) in gynecologic malignancies: an oncologic expert statement.

Author information

1
Division of Gynecology, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria. edgar.petru@medunigraz.at.
2
Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
3
Department of Obstetrics and Gynecology, Hanuschkrankenhaus, Vienna, Austria.
4
Department of Gynecology, Hospital Barmherzige BrĂ¼der Graz, Graz, Austria.
5
Department of Internal Medicine, Klinikum Klagenfurt, Klagenfurt, Austria.
6
Division of Gynecology, Department of Obstetrics and Gynecology, Medical University of Graz, Auenbruggerplatz 14, 8036, Graz, Austria.
7
Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria.
8
Department of Gynecology, Hospital Barmherzige Schwestern, Linz, Austria.
9
Department of Obstetrics and Gynecology, Wilhelminenspital, Vienna, Austria.
10
Department of Obstetrics and Gynecology, Paracelsus University of Salzburg, Salzburg, Austria.

Abstract

We reviewed the status of the use of the prophylactic long-acting granulocyte colony-stimulating factors (G-CSFs) pegfilgrastim and lipegfilgrastim in gynecologic malignancies. Long-acting G-CSFs should not be used in weekly regimens. Filgrastim is not indicated in patients with febrile and/or severe neutropenia after administration of long-acting G-CSF in the same cycle. One study has shown a moderate effect on febrile neutropenia of ciprofloxacin when co-administered with pegfilgrastim. There is broad evidence from meta-analyses that pegfilgrastim effectively reduces severe neutropenia. In parallel, its adverse effects have been studied extensively. All-cause mortality was significantly reduced by pegfilgrastim. The glycopegylated long-acting G-CSF, lipegfilgrastim has demonstrated antineutropenic efficacy similar to that of pegfilgrastimin in one breast cancer study. In another pivitol non-small cell lung cancer study, impaired survival was observed in the lipegfilgrastim group during the first 30 days of study. The European Medicines Agency claimed more profound safety data to be provided for lipegfilgrastim by 2017.

KEYWORDS:

Chemotherapy-induced neutropenia; Febrile neutropenia; Granulocyte colony-stimulating factors (G-CSF); Gynecologic cancer; Long-acting granulocyte colony stimulating factors

PMID:
26471371
DOI:
10.1007/s10354-015-0392-3
[Indexed for MEDLINE]

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