Abstract 2357
Background
International guidelines recommend the use of granulocyte colony stimulating factors (G-CSF), such as filgrastim, to prevent chemotherapy-induced febrile neutropenia (FN) and maintain chemotherapy dose to improve clinical outcomes. However, there are no clear recommendations for regimens with a rest period (duration between two cytotoxic administrations, within one cycle or between two different cycles) of ≤ 14 days. This study aimed to describe modalities of daily clinical use of biosimilar filgrastim in patients (pts) receiving chemotherapy regimens with a rest period of ≤ 14 days.
Methods
This multicentre, prospective, non‐interventional study was performed in France in pts receiving biosimilar filgrastim during cytotoxic chemotherapy with rest period of ≤ 14 days.
Results
A total of 1080 pts were enrolled, of which 953 were included in the full analysis set: 144 had lymphoma (DLBCL, N = 39; Hodgkin’s lymphoma, N = 105), and 809 had solid tumours (breast, N = 299; lung, N = 144; gastrointestinal [GI], N = 366 [colorectal, N = 203; pancreatic, N = 106; gastric N = 39; oesophageal, N = 18]). The Table shows modalities of filgrastim treatment for pts receiving chemotherapy for curative intent. Similar results were reported in pts receiving chemotherapy for palliative intent. Pts with solid tumours were planned to receive filgrastim on Day 2 of treatment for ≤5 days duration. Pts with lymphoma were planned to receive filgrastim on Day ≥3 for 4–8 days duration. Of the patients receiving chemotherapy for curative intent, FN was reported in 2 pts with GI cancer, 1 pt with lung cancer and 7 pts with lymphoma.Table:
1812P Modalities of use of biosimilar filgrastim in patients receiving chemotherapy for curative intent
Full group N (%) | Lymphoma 144 (15.1) | Solid tumours 809 (85) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Subgroup (intent of chemotherapy) | DLBCL (i) N = 35 | HL (i) N = 100 | Breast cancer (c) N = 139 | GI cancers (c) N = 126 | Lung cancer (c) N = 58 | ||||||
Regimen‡ | biw N = 23 | m N = 12 | biw N = 100 | qw N = 91 | biw N = 37 | m N = 11 | qw N = 1 | biw N = 120 | m N = 5 | qw N = 1 | m N = 57 |
Relative dose intensity with planned dose, % Mean (SD) | 97.7 (4.4) | - | 109.5 (94.9) | 100.9 (21.8) | 97.2 (10.4) | 95.2 (12.6) | - | 99.5 (24.0) | 96.4 (8.0) | - | 95.1 (28.4) |
Patients with at least one episode of grade 4 neutropenia† | |||||||||||
Yes n (%) | 3 (13.0) | 1 (8.3) | 11 (11.0) | 0 | 2 (5.4) | 0 | 0 | 1 (0.8) | 0 | 0 | 2 (3.5) |
Number of patients with at least one episode of FN† | |||||||||||
Yes n (%) | 1 (4.3) | 1 (8.3) | 5 (5.0) | 0 | 0 | 0 | 0 | 2 (1.7) | 0 | 0 | 1 (1.8) |
Note: percentages are calculated compared to completed data (i.e. not including missing data).
‡The most frequently used chemotherapies in the overall study population were:
DLBCL: R-ACVBP; R-CHOP 14.
HL: ABVD; increased-dose BEACOPP.
Breast cancer: eribulin; paclitaxel weekly.
Digestive cancers: simplified FolFOx4 (colorectal, gastric and oesophageal cancers); FolFlrinOx (pancreatic cancer).
Lung cancer: carboplatin + paclitaxel (weekly); vinorelbine + platinum salt (carboplatin or cisplatin) 21-day cycle.
biw, twice weekly regimen; c, curative; DLBCL, diffuse large B-cell lymphoma; FN, febrile neutropenia; GI, gastrointestinal; HL, Hodgkin’s lymphoma; i, induction; m, mixed regimen; N, number of patients in group; n, number of patients with event; qw, once weekly regimen; SD, standard deviation.
Conclusions
Biosimilar filgrastim treatment in pts receiving chemotherapy with a rest period of ≤ 14 days results in a low incidence of FN in real-world clinical practice.
Clinical trial identification
Editorial acknowledgement
Caroline McGown of Spirit Medical Communications Ltd, supported by Sandoz.
Legal entity responsible for the study
Sandoz.
Funding
Sandoz.
Disclosure
J.M. Phelip: Advisory / Consultancy: Roche; Advisory / Consultancy: Merck; Advisory / Consultancy: Amgen; Advisory / Consultancy: Sanofi; Advisory / Consultancy: Bayer; Advisory / Consultancy: Servier; Advisory / Consultancy: Lilly; Advisory / Consultancy: MSD; Advisory / Consultancy: Pierre Favre; Research grant / Funding (institution): Merck Serono. P. Souquet: Honoraria (self), Speaker Bureau / Expert testimony, Non-remunerated activity/ies: Sandoz (a Novartis company). M. Declerck: Full / Part-time employment: Sandoz. E. Nabirotchkina: Full / Part-time employment: Sandoz. O. Tredan: Non-remunerated activity/ies: Sandoz; Honoraria (self): Roche; Honoraria (self): Novartis; Honoraria (self): Pfizer; Honoraria (self): Lilly; Honoraria (self): Astra-Zeneca; Honoraria (self): MSD-Merck; Honoraria (self): BMS. All other authors have declared no conflicts of interest.
Resources from the same session
5995 - Invasive fungal diseases caused by rare pathogens in patients after hematopoietic stem cell transplantation (HSCT) & chemotherapy
Presenter: Yuliya Rogacheva
Session: Poster Display session 1
Resources:
Abstract
2961 - Safety and pharmacokinetics of novel CXCR4 antagonist YF-H-2015005 in the mobilization of hematopoietic stem cells in patients with non-Hodgkin's lymphoma
Presenter: Weiping Liu
Session: Poster Display session 1
Resources:
Abstract
5771 - Chemotherapy associated Hyponatremia in Hematological Malignancies: A retrospective study of 189 patients treated in a single medical center
Presenter: Vadim Lesan
Session: Poster Display session 1
Resources:
Abstract
1165 - Risk factors for Bacteremia-Associated Mortality of Aeromona sobria in Hematologic Malignancies
Presenter: Gabriel De la Cruz-Kú
Session: Poster Display session 1
Resources:
Abstract
5287 - Use of droplet digital polymerase chain reaction for detecting minimal residual disease: a prospective, multi-institutional study
Presenter: Hyunkyung Park
Session: Poster Display session 1
Resources:
Abstract
1886 - RUBIH2 — Use of NGS in haematological malignancies: from real world data to national recommendations, an innovative program to evaluate the impact of healthcare technology on patient care
Presenter: Severine Coquerelle
Session: Poster Display session 1
Resources:
Abstract
1940 - Outcomes of chronic myeloid leukemia with T315I mutation in the absence of targeted therapy or hematopoietic stem cell transplantation
Presenter: Nageswara Palukuri
Session: Poster Display session 1
Resources:
Abstract
1946 - Is bone marrow examination indispensible in chronic myeloid Leukemia at diagnosis ?
Presenter: Nageswara Palukuri
Session: Poster Display session 1
Resources:
Abstract
1904 - Incidence of Imatinib Resistance in Chronic Myeloid Leukemia (CML) Patients: Experience from Resource Poor Centre of Eastern India
Presenter: Debmalya Bhattacharyya
Session: Poster Display session 1
Resources:
Abstract
3245 - BCR-ABL transcript variant’s significance in chronic myeloid leukemia in chronic phase: Institutional experience from a developing country
Presenter: Siva Prasad
Session: Poster Display session 1
Resources:
Abstract