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Effectiveness and safety of primary prophylaxis of G-CSF during chemotherapy for prostate cancer, Japanese clinical guideline for appropriate use of G-CSF: clinical practice guidelines for the use of G-CSF 2022

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Abstract

Background

Docetaxel (DTX) is commonly used as a primary chemotherapy, and cabazitaxel (CBZ) has shown efficacy in patients who are DTX resistant. Primary prophylactic granulocyte colony stimulating factor (G-CSF) therapy is currently used with CBZ treatment in routine clinical care in Japan.

Methods

In this study, we performed a systematic review following the Minds guidelines to investigate the effectiveness and safety of primary prophylaxis with G-CSF during chemotherapy for prostate cancer and to construct G-CSF guidelines for primary prophylaxis use during chemotherapy. A comprehensive literature search of various electronic databases (PubMed, Cochrane Library, and Ichushi) was performed on January 10, 2020, to identify studies published between January 1990 and December 31, 2019 that investigate the impact of primary prophylaxis with G-CSF during CBZ administration on clinical outcomes.

Results

Ultimately, nine articles were included in the qualitative systematic review. Primary G-CSF prophylaxis during CBZ administration for metastatic castration-resistant prostate cancer was difficult to assess in terms of correlation with overall survival, mortality from infection, and patients’ quality of life. These difficulties were owing to the lack of randomized controlled trials comparing patients with and without primary prophylaxis of G-CSF during CBZ administration. However, some retrospective studies have suggested that it may reduce the incidence of febrile neutropenia.

Conclusion

G-CSF may be beneficial as primary prophylaxis during CBZ administration for metastatic castration resistant prostate cancer, and we made a “weak recommendation to perform” with an annotation of the relevant regimen.

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Acknowledgements

The authors thank Dr. Toshimi Takano and Ms. Natsuki Fukuda for their valuable comments and suggestions.

Funding

The present study did not receive any funding.

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Contributions

All authors contributed to the conception and design of the study. The first draft of the manuscript was written by S.K., and all authors commented on the previous version of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Yuji Miura.

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Kimura, S., Shigeta, K., Tamura, S. et al. Effectiveness and safety of primary prophylaxis of G-CSF during chemotherapy for prostate cancer, Japanese clinical guideline for appropriate use of G-CSF: clinical practice guidelines for the use of G-CSF 2022. Int J Clin Oncol 29, 559–563 (2024). https://doi.org/10.1007/s10147-024-02501-7

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  • DOI: https://doi.org/10.1007/s10147-024-02501-7

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