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01.10.2015 | review | Ausgabe 19-20/2015

Wiener Medizinische Wochenschrift 19-20/2015

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

Zeitschrift:
Wiener Medizinische Wochenschrift > Ausgabe 19-20/2015
Autoren:
Prof. Dr. Edgar Petru, MD Christian F. Singer, MD Stephan Polterauer, MD Arik Galid, MD Christian Schauer, MD Johann Klocker, MD Michael Seifert, MD Alexander Reinthaller, MD Christoph Benedicic, MD Michael Hubalek, MD Lukas Hefler, MD Christian Marth, MD Tonja Scholl-Firon, MD Gerhard Bogner, MD Alain-Gustave Zeimet

Summary

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.

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