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一项关于甲磺酸培非格司亭单次给药与粒细胞集落刺激因子治疗乳腺癌患者化疗所致中性粒细胞减少症的随机多中心II期试验。

A randomized multicenter phase II trial of mecapegfilgrastim single administration versus granulocyte colony-stimulating growth factor on treating chemotherapy-induced neutropenia in breast cancer patients.

作者信息

Wang Tao, Wu Biao, Hu Xichun, Liu Jinping, Zhang Tao, Li Funian, Sun Bing, Cai Li, Li Xinzheng, Chen Zhiyue, Yang Qing, Jiang Zefei

机构信息

Department of Breast Oncology, The Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China.

Department of Breast Oncology, The First Affiliated Hospital of Nanchang University, Nanchang 330019, China.

出版信息

Ann Transl Med. 2019 May;7(9):196. doi: 10.21037/atm.2019.04.10.

Abstract

BACKGROUND

This study aimed to evaluate the efficacy and safety of mecapegfilgrastim (HHPG-19K) with different doses compared to granulocyte colony-stimulating growth factor (G-CSF) in treating chemotherapy-induced neutropenia in breast cancer patients.

METHODS

A total of 182 breast cancer patients were enrolled in this multi-center, randomized, phase II trial and developed neutropenia after first cycle chemotherapy. Patients were then assigned as 1:1:1 ratio to receive 100 µg/kg HHPG-19K single injection (HHPG-19K-N group), 150 µg/kg HHPG-19Ksingle injection (HHPG-19K-H group) and 5 µg/kg G-CSF daily injection (G-CSF group) at day 3 of the second cycle (cycle 2) chemotherapy. The primary endpoint was incidence of grade ≥3 neutropenia during cycle 2. Study drug-related adverse events during cycle 2 were recorded for safety assessment.

RESULTS

During cycle 2 chemotherapy, both HHPG-19K-N and HHPG-19K-H groups exhibited lower incidence of grade ≥3 neutropenia compared with G-CSF group, while no difference was observed between HHPG-19K-N and HHPG-19K-H groups. Also, better outcomes were observed in HHPG-19K-N and HHPG-19K-H groups compared with G-CSF group regarding to grade 4 neutropenia, duration of grade ≥3 neutropenia, duration of grade 4 neutropenia, incidence of febrile neutropenia (FN) and rescue application of G-CSF, time to ANC recovery, while no difference of these outcomes between HHPG-19K-N and HHPG-19K-H groups was observed. For safety analysis, the incidences of hematologic and non-hematologic adverse events were similar among the 3 groups.

CONCLUSIONS

HHPG-19K presents with better clinical efficacy as well as equal tolerance compared with G-CSF in treating chemotherapy-induced neutropenia in breast cancer patients.

摘要

背景

本研究旨在评估不同剂量的甲培非格司亭(HHPG-19K)与粒细胞集落刺激因子(G-CSF)相比,在治疗乳腺癌患者化疗所致中性粒细胞减少症方面的疗效和安全性。

方法

总共182例乳腺癌患者被纳入这项多中心、随机、II期试验,且在首个化疗周期后出现了中性粒细胞减少症。然后患者按1:1:1的比例被分配,在第二个化疗周期(周期2)的第3天接受100μg/kg HHPG-19K单次注射(HHPG-19K-N组)、150μg/kg HHPG-19K单次注射(HHPG-19K-H组)以及5μg/kg G-CSF每日注射(G-CSF组)。主要终点是周期2期间≥3级中性粒细胞减少症的发生率。记录周期2期间与研究药物相关的不良事件以进行安全性评估。

结果

在周期2化疗期间,与G-CSF组相比,HHPG-19K-N组和HHPG-19K-H组的≥3级中性粒细胞减少症发生率均较低,而HHPG-19K-N组和HHPG-19K-H组之间未观察到差异。此外,在4级中性粒细胞减少症、≥3级中性粒细胞减少症持续时间、4级中性粒细胞减少症持续时间、发热性中性粒细胞减少症(FN)发生率以及G-CSF的挽救性应用、中性粒细胞绝对值(ANC)恢复时间方面,HHPG-19K-N组和HHPG-19K-H组与G-CSF组相比观察到更好的结果,而HHPG-19K-N组和HHPG-19K-H组之间这些结果未观察到差异。对于安全性分析,3组中血液学和非血液学不良事件的发生率相似。

结论

在治疗乳腺癌患者化疗所致中性粒细胞减少症方面,HHPG-19K与G-CSF相比具有更好的临床疗效以及相同的耐受性。

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