March 8, 2009

Prophylactic Neulasta® Reduces Febrile Neutropenia and Early Deaths Among Patients Receiving Chemotherapy


Prophylactic Neulasta® Reduces Febrile Neutropenia and Early Deaths Among Patients Receiving Chemotherapy

Prophylactic use of Neulasta® (pegfilgrastim) among cancer patients receiving chemotherapy reduces the risk of developing febrile neutropenia and early death. These results were recently published in the Journal of Clinical Oncology.

Chemotherapy remains the cornerstone of treatment for patients with cancer. Unfortunately, chemotherapy is associated with side effects, including low levels of immune cells-a condition referred to as neutropenia. Patients with neutropenia can become susceptible to infection with bacteria, viruses, and/or fungus. Among patients with neutropenia accompanied by fever (febrile neutropenia [FN]), even the slightest infection can become life-threatening. Patients with FN typically must have their treatment doses delayed or reduced, which decreases chances for the best outcomes.

Fortunately, neutropenic patients can receive blood cell boosters (growth factors) such as Neulasta, which are given by injection during chemotherapy cycles. Neulasta has the ability to reduce infections, hospitalizations, medical cost, dose delays, and death associated with infection in neutropenic patients. The FDA has approved Neulasta to be given 14 days before initiation of chemotherapy or at least 24 hours following initiation of chemotherapy. Researchers continue to evaluate the effects of Neulasta among patients who are at risk for FN.

Researchers recently reviewed data from trials evaluating Neulasta used to prevent neutropenia among patients undergoing chemotherapy. This review included 17 trials and 3,493 patients and compared Neulasta with placebo (inactive substitute) or no agent to prevent neutropenia.

  • Patients treated with Neulasta had a 45% reduction in death related to infection.
  • Patients treated with Neulasta had 40% reduction in death during chemotherapy.
  • Febrile neutropenia was reduced by 46% among patients treated with Neulasta.
  • Patients treated with Neulasta had a significantly improved rate of receiving greater dose-intensity (combination of dose and schedule) therapy.
  • Patients treated with Neulasta had higher rates of muscular and skeletal pain.

The researchers concluded that prophylactic Neulasta reduces FN, death during chemotherapy, and death associated with infection among cancer patients undergoing chemotherapy. Longer follow-up is necessary to determine the effects of Neulasta on overall survival for these patients.

Patients who are to undergo chemotherapy may wish to speak with their physician regarding their individual risks and benefits of prophylactic use of Neulasta.

Reference: Kuderer N, Dale D, Crawford J, Lyman G. Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systemic review. Journal of Clinical Oncology. 2007; 21:3158-3167.

Related News: Neulasta® Reduces Hospitalizations for Febrile Neutropenia in Women with Breast Cancer (10/2/2007)

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