Risk of chemotherapy-induced febrile neutropenia in cancer patients receiving pegfilgrastim prophylaxis: does timing of administration matter?

Purpose: Contrary to the approved indication for pegfilgrastim prophylaxis, some patients receive it on the same day as the last administration of chemotherapy in clinical practice, which could adversely impact risk of febrile neutropenia (FN). An evaluation of the timing of pegfilgrastim prophylaxi...

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Publicado en:Supportive Care in Cancer Vol. 24; no. 5; pp. 2309 - 2317
Autores principales: Weycker, Derek, Li, Xiaoyan, Figueredo, Jacqueline, Barron, Rich, Tzivelekis, Spiros, Hagiwara, May
Formato: research Journal Article
Publicado: Springer Nature May2016
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00520-015-3036-7
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        atl: Risk of chemotherapy-induced febrile neutropenia in cancer patients receiving pegfilgrastim prophylaxis: does timing of administration matter?
      aug:
        au:
          Weycker, Derek
          Li, Xiaoyan
          Figueredo, Jacqueline
          Barron, Rich
          Tzivelekis, Spiros
          Hagiwara, May
        affil: Policy Analysis Inc. (PAI), Four Davis Court Brookline 02445 USA
      sug:
        subj:
          Lymphoma, Non-Hodgkin's Drug Therapy
          Granulocyte Colony-Stimulating Factor Metabolism
          Neutropenia Etiology
          Recombinant Proteins Adverse Effects
          Granulocyte Colony-Stimulating Factor Adverse Effects
          Retrospective Design
          Human
          Recombinant Proteins Administration and Dosage
          Granulocyte Colony-Stimulating Factor Administration and Dosage
          Male
          Middle Age
          Female
          Prospective Studies
          Granulocyte Colony-Stimulating Factor Therapeutic Use
          Recombinant Proteins Therapeutic Use
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Middle Aged: 45-64 years
          Male
          Female
      ab: Purpose: Contrary to the approved indication for pegfilgrastim prophylaxis, some patients receive it on the same day as the last administration of chemotherapy in clinical practice, which could adversely impact risk of febrile neutropenia (FN). An evaluation of the timing of pegfilgrastim prophylaxis and FN risk was undertaken.Methods: A retrospective cohort design and data from two US private health care claims repositories were employed. Study population comprised adults who received intermediate/high-risk chemotherapy regimens for solid tumors or non-Hodgkin's lymphoma (NHL) and received pegfilgrastim prophylaxis in ≥1 cycle; all cycles with pegfilgrastim were pooled for analyses. Odds ratios (OR) for FN during the cycle were estimated for patients who received pegfilgrastim on the same day (day 1) as the last administration of chemotherapy versus days 2-4 from chemotherapy completion.Results: The study population included 45,592 patients who received pegfilgrastim in 179,152 cycles (n = 37,095 in cycle 1); in 12 % of cycles, patients received pegfilgrastim on the same day as chemotherapy. Odds of FN were higher for patients receiving pegfilgrastim prophylaxis on the same day as chemotherapy versus days 2-4 from chemotherapy in cycle 1 (OR = 1.6, 95 % CI = 1.3-1.9, p < 0.001) and all cycles (OR = 1.5, 95 % CI = 1.3-1.6, p < 0.001).Conclusions: In this large-scale evaluation of adults who received intermediate/high-risk regimens for solid tumors or NHL in US clinical practice, FN incidence was found to be significantly higher among those who received pegfilgrastim prophylaxis on the same day as chemotherapy completion versus days 2-4 from chemotherapy completion, underscoring the importance of adhering to the indicated administration schedule.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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