Abstract
Background
Granulocyte colony-stimulating factor (G-CSF) is commonly administered to cancer patients undergoing myelosuppressive chemotherapy, especially when incidence rate of febrile neutropenia (FN) surpasses 20%. While primary prophylaxis with G-CSF has been proven effective in preventing FN in patients with cancer, there is limited evidence regarding its efficacy in specifically, lung cancer. Our systematic review focused on the efficacy of G-CSF primary prophylaxis in lung cancer.
Methods
We extracted studies on non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) using the PubMed, Ichushi Web, and Cochrane Library databases. Two reviewers assessed the extracted studies for each type of lung cancer and conducted quantitative and meta-analyses of preplanned outcomes, including overall survival, FN incidence, infection-related mortality, quality of life, and musculoskeletal pain.
Results
A limited number of studies were extracted: two on NSCLC and six on SCLC. A meta-analysis was not conducted owing to insufficient data on NSCLC. Two case–control studies explored the efficacy of primary prophylaxis with G-CSF in patients with NSCLC (on docetaxel and ramucirumab therapy) and indicated a lower FN frequency with G-CSF. For SCLC, meta-analysis of five studies showed no significant reduction in FN incidence, with an odds ratio of 0.38 (95% confidence interval 0.03–5.56, P = 0.48). Outcomes other than FN incidence could not be evaluated due to low data availability.
Conclusion
Limited data are available on G-CSF prophylaxis in lung cancer. Primary prophylaxis with G-CSF may be weakly recommended in Japanese patients with NSCLC undergoing docetaxel and ramucirumab combination therapy.
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Data availability
Data associated with this systematic review can be accessed from the corresponding author upon reasonable request.
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Acknowledgements
We thank Natsuki Narita for her support of our systematic review. We would like to thank Editage (www.editage.jp) for English language editing.
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All the authors contributed to the conception and design of this study. E.I. wrote the draft of the manuscript, and all authors reviewed and commented on the manuscript.
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Eiki Ichihara received honoraria from Eli Lilly and research funding from MSD, Ono Pharmaceutical, Jansen Pharma, and Takeda Pharmaceutical. Go Makimoto received honoraria from Kyowa Kirin. Yukinori Ozaki received honoraria from Daiichi-Sankyo, Pfizer, Chugai, Lilly, and Kyowa Kirin. Kenji Tsuchihashi received honoraria from Ono Pharmaceutical, Chugai Pharmaceutical, Taiho Pharmaceutical, and Novartis Pharma. Yuji Miura received honoraria from Ono Pharmaceutical, MSD, Takeda Pharmaceuticals, Eisai, Bristol Myers Squibb, and research funding from Ono Pharmaceutical and MSD. Shingo Yano received research funding from Otsuka Pharmaceutical. Dai Maruyama received honoraria from Ono Pharmaceutical, Janssen Pharma, Nippon Shinyaku, Eisai, Mundipharma, Kyowa Kirin, Chugai Pharmaceutical, Zenyaku, MSD, SymBio, Sanofi, AbbVie, Takeda Pharmaceutical, AstraZeneca, Bristol Myers Squibb, and Genmab, and research funding from Amgen, Astellas Biopharma, Novartis, Kyowa Kirin, Ono Pharmaceutical, Chugai Pharmaceutical, Janssen Pharma, Takeda Pharmaceutical, Otsuka Pharmaceutical, Sanofi, Astellas, Bristol Myers Squibb, AbbVie, Eisai, MSD, Taiho Pharmaceutical, AstraZeneca, Eli Lilly, and Genmab. Tetsuhiro Yoshinami received honoraria from Kyowa Kirin, Pfizer, Chugai Pharmaceutical, Eli Lilly, MSD, AstraZeneca, and Eizai. Takashi Motohashi received honoraria from AstraZeneca, Chugai Pharmaceutical, and Myriad Genetics. Eishi Baba received honoraria from Chugai Pharmaceutical and Daiichi-Sankyo, and research funding from Taiho Pharmaceutical and Chugai Pharmaceutical. Takahiro Kimura received honoraria from Sanofi. Shinji Nakao received honoraria from Kyowa Kirin. Atsushi Sato received honoraria from Chugai Pharmaceutical, and Taiho Pharmaceutical. Atsushi Sato received research funding from Chugai Pharmaceutical, and Taiho Pharmaceutical. Toshimi Takano received honoraria from Daiichi-Sankyo, Chugai Pharmaceutical, and Eli Lilly. Toshio Kubo received honoraria from Chugai Pharmaceutical.
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Ichihara, E., Ochi, N., Makimoto, G. et al. Effectiveness and safety of primary prophylaxis with G-CSF for lung cancer: a systematic review and meta-analysis to develop clinical practice guidelines for the use of G-CSF 2022. Int J Clin Oncol 29, 355–362 (2024). https://doi.org/10.1007/s10147-024-02469-4
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DOI: https://doi.org/10.1007/s10147-024-02469-4