According to results presented at the 27th annual meeting of the European Society of Medical Oncology (ESMO), further evidence was presented indicating that Neulasta™ (pegfilgrastim) appears to reduce the incidence of neutropenia in patients being treated for breast cancer1.Chemotherapy not only destroys cancer cells, but also normal cells that grow rapidly, such as blood cells forming in the bone marrow, cells in the hair follicles, or cells in the mouth and intestines. Neutropenia occurs when white blood cells (immune cells) are destroyed by chemotherapy, leaving the immune system unable to fight bacterial, viral and fungal infections. Chemotherapy induced neutropenia can become a serious condition for several reasons: the majority of patients who develop neutropenia will require a dose reduction in their treatment which may reduce survival rates2,3, patients who develop neutropenia may require hospitalization and even minor infections can become life threatening.
Neupogen® is an agent that stimulates the production of white blood cells and is approved for the treatment of neutropenia. However, the drawback of Neupogen® is that it must be administered daily. In an effort to address the daily dose requirements of Neupogen®, researchers developed Neulasta™, which also stimulates the production of white blood cells. Unlike Neupogen®, Neulasta™ may be administered as a single dose per chemotherapy cycle. Previous clinical trials have indicated that Neulasta™ reduces the incidence and/or severity of neutropenia in patients undergoing treatment for non-myeloid (blood) cancer and further trials are being conducted to determine the true clinical efficacy of treatment with Neulasta™.
Results presented at ESMO involved two clinical trials evaluating Neulasta™ in patients diagnosed with breast cancer. One clinical trial compared the incidence of febrile neutropenia (neutropenia accompanied by a fever) in patients treated with Neulasta™ or Neupogen® while the second clinical trial compared the incidence of febrile neutropenia in patients treated with Neulasta™ or no support therapy for neutropenia. In the first trial, only 11% of patients treated with one injection of Neulasta™ experienced febrile neutropenia, compared to 19% of patients treated with daily Neupogen® injections. In the second trial, 19% of patients treated with Neulasta™ experienced febrile neutropenia, compared to 38% of patients treated with no support for neutropenia.
These results provide further evidence suggesting that Neulasta™ reduces the incidence of febrile neutropenia in patients undergoing treatment for non-myeloid cancer. Patients who are scheduled to undergo cancer therapy may wish to discuss the risks and benefits of Neulasta™ with their physician or the participation in a clinical trial further evaluating Neulasta™. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.
- Siena S, Piccart M, Holmes FA, Glaspy J, Hackett J, Renwick J. A single dose of pegfilgrastim per chemotherapy cycle reduces the incidence and duration of febrile neutropenia (FN) compared with daily Filgrastim: a meta-analysis of two phase 3 randomised trials in patients with stage II-IV breast cancer. Presented at the ESMO Congress 2002. Abstract 645.
- Awareness of Neutropenia in Chemotherapy, 2001; 1(1): 3-4.
- Bonadonna G, Valag ussa P, Moliterni A, et al. Adjuvant cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer: the results of 20 years of follow-up.
The New England Journal of Medicine. 1995;332:901-906.
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