Evidence-Based Use of Hematopoietic Cytokines in Clinical Oncology

  • George D. Demetri
Part of the Developments in Oncology book series (DION, volume 80)


The history of medicine is replete with examples which show how certain new technology and new therapeutics improve clinical outcomes. The introduction of hematopoietic cytokines into the clinical practice of oncology represents one of the more interesting recent examples of technologic innovation translating into clinical therapeutics. The corporate-sponsored research that tested these recombinant agents in humans set new standards for rapidly turning laboratory findings such as cloned human cytokine genes into useful therapeutic compounds such as recombinant human granulocyte colony-stimulating factor (G-CSF), recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF), and recombinant human erythropoietin (epoetin alfa, EPO). However, once G-CSF, GM-CSF, and EPO were commercially available for broad use by oncologists, it became clear that the optimal and appropriate use of these agents required more study and analysis. It is important also to note that hematopoietic cytokines are not unique in cancer medicine: many new cancer therapeutic agents are very expensive, and after initial regulatory approval, the field of oncology continually re-assesses the use of new agents. Often, for cytotoxic chemotherapies, this involves more broad use of a new agent outside of the initial tumor type for which the drug was approved (so-called “off label” use in practice). Such expansion of chemotherapy use can yield important new uses for a drug.


Primary Prophylaxis Autologous Bone Marrow Transplantation Secondary Prophylaxis Myelosuppressive Chemotherapy Hematopoietic Cytokine 
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© Springer Science+Business Media New York 1999

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  • George D. Demetri

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