Timing Matters for Pegfilgrastim Administration

The incidence of febrile neutropenia was significantly higher among patients who received pegfilgrastim prophylaxis on the same day.
The incidence of febrile neutropenia was significantly higher among patients who received pegfilgrastim prophylaxis on the same day.

In adults who received intermediate or high-risk regimens for solid tumors or non-Hodgkin lymphoma (NHL), the incidence of febrile neutropenia was significantly higher among patients who received pegfilgrastim prophylaxis on the same day as chemotherapy completion compared with those who received it days 2 to 4 from chemotherapy completion, a new study published online ahead of print in the journal Supportive Care in Cancer has shown.1

Although pegfilgrastim prophylaxis is not approved for administration between 14 days before and 24 hours after administration of cytotoxic chemotherapy, some patients still receive the granulocyte colony-stimulating factor on the same day as the last administration of chemotherapy in clinical practice, which may increase the risk of febrile neutropenia. Therefore, researchers sought to evaluate the timing of pegfilgrastim prophylaxis and febrile neutropenia risk.

For the retrospective study, researchers analyzed data from 45 592 patients from 2 US private health care claims repositories who received pegfilgrastim in 179 152 cycles of chemotherapy. Patients had solid tumors or NHL, for which they received intermediate or high-risk chemotherapy regimens and pegfilgrastim prophylaxis in 1 or more cycles.

Researchers found that in 12% of cycles, patients received pegfilgrastim on the same day as chemotherapy. Results showed that odds of febrile neutropenia were higher for patients receiving pegfilgrastim prophylaxis on the same day as chemotherapy vs days 2 to 4 from chemotherapy in cycle 1 and all cycles (P<.001).

The authors note that the findings underscore the importance of adhering to the indicated pegfilgrastim administration schedule in patients receiving myelosuppressive chemotherapy.

REFERENCE

1. Weycker D, Li X, Figueredo J, et al. Risk of chemotherapy-induced febrile neutropenia in cancer patients receiving pegfilgrastim prophylaxis: does timing of administration matter? [published online ahead of print November 25, 2015]. Supp Care Cancer. doi:10.1007/s00520-015-3036-7.

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