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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

3482 - A randomized, open-label, non-inferiority study comparing the efficacy and safety of lipegfilgrastim versus pegfilgrastim in elderly patients with aggressive B-cell Non-Hodgkin lymphomas (B-NHL) - AVOID Neutropenia.

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Tumour Site

Lymphomas

Presenters

Hartmut Link

Citation

Annals of Oncology (2018) 29 (suppl_8): viii603-viii640. 10.1093/annonc/mdy300

Authors

H. Link1, G. Illerhaus2, U.M. Martens3, A. Salar4, R. Depenbusch5, A. Kohler6, M.M. Engelhardt7, S. Mahlmann8, M. Zaiss9, A. Lammerich10, P. Bias10, A. Buchner11

Author affiliations

  • 1 Praxis Professor Link, Praxis Professor Link, 67653 - Kaiserslautern/DE
  • 2 Klinik Für Hämatologie, Onkologie Und Palliativmedizin, Klinikum Stuttgart - Olgahospital, 70174 - Stuttgart/DE
  • 3 Klinik Für Innere Medizin Iii, SLK-Kliniken Heilbronn GmbH, 74078 - Heilbronn/DE
  • 4 Hematology Department, Hospital del Mar, 08003 - Barcelona/ES
  • 5 Onkodok Gmbh, Onkodok GmbH, 33332 - Gütersloh/DE
  • 6 Gemeinschaftspraxis Für Hämatologie Und Onkologie Dres. Köhler/fuchs, Gemeinschaftspraxis für Hämatologie und Onkologie Dres. Köhler/Fuchs, 63225 - Langen/DE
  • 7 Hämatologie, Onkologie Und Stammzelltransplantation, University of Freiburg Medical Centre, 79106 - Freiburg/DE
  • 8 Klinik Für Innere Medizin I, Hämatologie, Onkologie Und Stammzelltransplantation, Westpfalz-Klinikum GmbH, 67655 - Kaiserslautern/DE
  • 9 Praxis Für Interdisziplinäre Onkologie & Hämatologie, Praxis für Interdisziplinaere Onkologie, 79110 - Freiburg/DE
  • 10 Clinical Development, Merckle GmbH, 89079 - Ulm/DE
  • 11 Clinical Development, Merckle GmbH, Ulm/DE

Resources

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Abstract 3482

Background

Lipegfilgrastim (LONQUEX®) has proven to be non-inferior to pegfilgrastim (NEULASTA®) in the reduction of the duration of severe neutropenia (DSN) in breast cancer patients. The efficacy and safety of lipegfilgrastim versus pegfilgrastim in elderly patients with B-NHL at high risk for R-CHOP-21-induced neutropenia was investigated. The primary efficacy endpoint was the DSN in cycle 1.

Methods

One hundred and one patients with NHL, median age of 74 years, were randomized to receive either 6 mg of lipegfilgrastim or pegfilgrastim per cycle during 6 cycles of R-CHOP-21.

Results

Lipegfilgrastim was non-inferior to pegfilgrastim in the DSN in cycle 1: the mean DSN (days) in cycle 1 was 0.8±.96 and 0.9±1.08 in the per-protocol population, respectively with an adjusted mean difference (95% confidence interval) between groups of -0.3 (-0.70, 0.19). The upper boundary was below the predefined non-inferiority margin of 1. Non-inferiority was also demonstrated in the intent-to-treat population. The incidence of febrile neutropenia (FN) in cycle 1 was 2% (1/41) in the lipegfilgrastim and 0% (0/44) in the pegfilgrastim group. The incidence of severe neutropenia in cycle 1 was similar in the lipegfilgrastim (21/41; 51%) and pegfilgrastim (23/44; 52%) groups. The mean time to absolute neutrophil count recovery to a threshold of ≥ 2.0 × 109/L was similar in lipegfilgrastim (8.3 days) and pegfilgrastim (8.7 days) groups. Adverse events (AEs) occurred in 98% of patients; in 45/46 of lipegfilgrastim and 49/50 of the pegfilgrastim group. Serious AEs occurred in 46% of patients; 21/46 in the lipegfilgrastim and 23/50 in pegfilgrastim group; none were assessed as treatment-related by the investigator. Fatal AEs occurred in 4% (2/46) of lipegfilgrastim and 10% (5/50) of the pegfilgrastim group. Study withdrawal due to AEs occurred in 2% (1/46) of the lipegfilgrastim and 18% (9/50) of the pegfilgrastim group.

Conclusions

Lipegfilgrastim was non-inferior to pegfilgrastim in the reduction of the DSN in elderly patients with B-NHL. The safety of lipegfilgrastim was comparable to pegfilgrastim.

Clinical trial identification

EudraCT: 2013-001284-23.

Legal entity responsible for the study

Merckle GmbH (part of Teva Pharmaceuticals group).

Funding

Merckle GmbH (part of Teva Pharmaceuticals group).

Editorial Acknowledgement

Disclosure

H. Link: Advisory boards, investigator in sponsored trial: Teva. G. Illerhaus, U.M. Martens, A. Salar, R. Depenbusch, A. Kohler, M.M. Engelhardt, S. Mahlmann, M. Zaiss: Investigator in Teva sponsored trial. A. Lammerich, P. Bias, A. Buchner: Employee and stock options: Teva.

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