The following article features coverage from the 2021 ASCO Quality Care Symposium. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

No significant differences in febrile neutropenia (FN) were observed between same-day and next-day administration of prophylactic pegfilgrastim in patients receiving myelosuppressive chemotherapy. These findings were presented during the 2021 ASCO Quality Care Symposium.

Patients receiving myelosuppressive chemotherapy are at risk for febrile neutropenia. Pegfilgrastim prophylaxis is administered within 24 to 72 hours after each cycle to reduce this risk; however, the ideal timing of pegfilgrastim administration within that window remains unclear. Researchers from Utah Cancer Specialists retrospectively reviewed patient records from 2018 to 2020 to assess whether real-world data supported a specific prophylaxis schedule.

This study included 297 patients with breast cancer (63.6%), lymphoma (23.6%), or other cancers (12.8%), and the most common chemotherapy was dose-dense doxorubicin and cyclophosphamide (43.4%).


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At cycle 1, 39.7% received same-day and 60.3% received next-day prophylaxis. At cycle 2, the pegfilgrastim dosing schedule was changed for 27 patients (4 patients in the same-day group and 23 patients in the next-day group).

Febrile neutropenia occurred after cycle 1 in 6.0% of the same-day group and 6.7% of the next-day group. After all cycles, 9.3% in the same-day and 8.9% in the next-day groups experienced 1 or more episodes of febrile neutropenia.

Incidence was not significantly different on the basis of schedule after cycle 1 (0.68%; 95% CI, -5.0% to 6.3%; P =.814) or all cycles (-0.38%; 95% CI, -7.1% to 6.3%; P =.910).

These data were sourced from a single center and may not be generalizable for other clinical settings.

The study authors concluded that these data support same-day dosing of prophylactic pegfilgrastim for the prevention of febrile neutropenia. This schedule reduces burden on patients and the healthcare system without increasing risk.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Read more of Oncology Nurse Advisor’s coverage of the 2021 ASCO Quality Care Symposium by visiting the conference page.

Reference

Kitchen K, Mosier MC. Real-world comparison of febrile neutropenia rates with same-day versus next-day administration of pegfilgrastim. J Clin Oncol. 2021;39(suppl 28):abstr 299. doi:10.1200/JCO.2020.39.28_suppl.299