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利培格司亭给药预防化疗引起的中性粒细胞减少症对剂量调整和中性粒细胞减少症事件发生率的影响:来自比利时和卢森堡非干预性研究的真实世界证据。

Effect of lipegfilgrastim administration as prophylaxis of chemotherapy-induced neutropenia on dose modification and incidence of neutropenic events: real-world evidence from a non-interventional study in Belgium and Luxembourg.

机构信息

Department of Medical Oncology, UZ Brussel , Brussel, Belgium.

Oncology Department, AZ Sint-Jan Brugge - Oostende AV , Brugge, Belgium.

出版信息

Acta Clin Belg. 2021 Feb;76(1):10-15. doi: 10.1080/17843286.2019.1646539. Epub 2019 Aug 9.

DOI:10.1080/17843286.2019.1646539
PMID:31399016
Abstract

: This study evaluated the effect of lipegfilgrastim, a glycopegylated granulocyte-colony stimulating factor, used as primary (PP) or secondary prophylaxis (SP) on chemotherapy (CT) treatment modifications, as well as the incidence of CT-induced neutropenic events in adult patients receiving cytotoxic CT with or without biological therapy (BT) for solid and hematological tumors, in routine clinical practice. Other objectives were to characterize the population of lipegfilgrastim-treated cancer patients and safety assessment. : This phase 4, prospective, observational study was conducted at 15 centers from Belgium and Luxembourg, between 2015 and 2017. : Of 139 patients, 82.7% had breast cancer and 54.7% were treated with dose-dense regimens. Most received lipegfilgrastim as PP (82.0%) and were at high-risk of febrile neutropenia (FN) (68.3%). FN and grade III/IV neutropenia were reported for 7.9% and 22.3% patients. Among 123 evaluated patients, CT/BT dose modifications were recorded for 33.3% (PP) and 52.4% (SP) of patients receiving lipegfilgrastim; dose reductions, followed by dose delays, were more frequent than omissions. Among 45 patients with dose modifications, FN was reported for 8.8% and 9.1% patients and grade IV neutropenia for 17.6% and 18.2% of patients when lipegfilgrastim was applied for PP and SP, respectively. Adverse events related to lipegfilgrastim occurred for 55 (39.6%) patients; bone pain and back pain were more frequent. Lipegfilgrastim-related serious adverse events were reported for 9 (6.5%) patients. : Use of lipegfilgrastim in real-world settings resulted in limited CT dose modifications and low incidences of neutropenic events, with no new safety concerns arising.

摘要

本研究评估了利培格非司亭(一种糖基化粒细胞集落刺激因子)作为初级(PP)或二级预防(SP)在接受细胞毒性化疗(CT)治疗且伴有或不伴有生物治疗(BT)的实体瘤和血液系统肿瘤成人患者中的应用对化疗治疗调整的影响,以及对 CT 诱导的中性粒细胞减少事件的发生率的影响。其他目的是描述接受利培格非司亭治疗的癌症患者人群,并进行安全性评估。

这是一项在比利时和卢森堡的 15 个中心开展的 2015 至 2017 年期间进行的 4 期、前瞻性、观察性研究。

在 139 例患者中,82.7%患有乳腺癌,54.7%接受了密集型方案治疗。大多数患者接受了利培格非司亭的 PP 治疗(82.0%),且具有高热中性粒细胞减少症(FN)的高危风险(68.3%)。报告了 7.9%和 22.3%的患者出现 FN 和 3 级/4 级中性粒细胞减少症。在 123 例接受评估的患者中,接受利培格非司亭治疗的患者中有 33.3%(PP)和 52.4%(SP)发生了 CT/BT 剂量调整;剂量减少后,随后是剂量延迟,比药物遗漏更常见。在 45 例剂量调整的患者中,利培格非司亭用于 PP 和 SP 时,分别有 8.8%和 9.1%的患者报告出现 FN,17.6%和 18.2%的患者出现 4 级中性粒细胞减少症。55 例(39.6%)患者发生与利培格非司亭相关的不良事件;更常见的是骨痛和背痛。9 例(6.5%)患者报告了与利培格非司亭相关的严重不良事件。

在真实环境中使用利培格非司亭可导致有限的 CT 剂量调整和中性粒细胞减少事件发生率低,没有出现新的安全性问题。

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