1556P - Use of a granulocyte-colony stimulating factor (G-CSF) as primary or secondary prophylaxis for chemo-induced febrile neutropenia (FN): results of th...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Complications/Toxicities of Treatment
Supportive Measures
Presenter Jean-Pierre Lotz
Authors J. Lotz
  • Hôpital Tenon, 75020 - Paris/FR



Febrile neutropenia (FN) occurs in 25% to 40% of patients receiving common chemotherapy (CT) regimens. The use of granulocyte-colony stimulating factor (G-CSF) is well recognized to prevent or to treat FN. The purpose of the present survey was to describe the use of a G-CSF (Tevagrastim®) in routine oncology practice.


The ObStim study is a French open-label, multicentre, prospective, observational (non-interventional) survey conducted over a period of 12 months in patients receiving CT. Patients were recruited if they had received Tevagrastim® for prevention of FN without predefined exclusion criteria, except patient's refusal or enrolment in another trial. The primary objective was to describe the prescription of Tevagrastim® according to patients' characteristics, CT regimens, and type of prophylaxis. Secondary objectives were: FN leading to secondary prophylaxis, number of CT cycles with Tevagrastim®, rank of CT cycles, dose and duration of Tevagrastimâ, CT delays and dose changes.


354 patients were recruited (primary prophylaxis [PP]: 65.8%; secondary prophylaxis [SP]: 34.2%). The median age was 62 years, irrespective of the type of prophylaxis. The main primary tumors were: breast, lung, lymphoma, colorectal, ovary, pancreas and bladder. Overall, 35% of patients were metastatic. It was the first CT for 80% of patients, and CT regimen consisted of a polyCT in more than 99% of cases. The median delivered dose of Tevagrastim® was 30 MUI/kg/day subcutaneously for a median duration of 5.4 days per cycle. The characteristics of FN leading to a SP were: grade 3-4 neutropenia (grade 4: 47.7%), median fever of 38.6°C, and median duration of fever of 2 days. The SP was set up at the 2nd cycle in median. As regards the MASCC (Multinational Association for Supportive Care in Cancer) score, it was lower than 21 (high-risk group) for 39% of patients (PP: 35.8%; SP: 44.3%).


Overall, the international guidelines for the prophylactic use of G-CSF of chemo-induced FN were well respected. Interestingly, Tevagrastim® was prescribed in more than 60% of low-risk patients for FN.


All authors have declared no conflicts of interest.