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比较 PDLASTA®(培非格司亭)与 PDGRASTIM®(非格司亭)在乳腺癌患者中的疗效和副作用:一项非劣效性随机临床试验。

Comparing the efficacy and side-effects of PDLASTA® (Pegfilgrastim) with PDGRASTIM® (Filgrastim) in breast cancer patients: a non-inferiority randomized clinical trial.

机构信息

Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.

Department of Hematology and Medical Oncology, Firoozgar Hospital, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Cancer. 2021 Apr 23;21(1):454. doi: 10.1186/s12885-021-08197-6.

Abstract

BACKGROUND

The objective of this study was to compare the efficacy and side effects of a single dose (Pegfilgrastim or PDL) or repeated six daily injections (Filgrastim or PDG) during chemotherapy courses in breast cancer patients in a non-inferiority clinical trial.

METHODS

In this randomized clinical trial, 80 patients were recruited and allocated randomly to two equal arms. In one group, a single subcutaneous dose of PDL was injected the day after receiving the chemotherapy regimen in each cycle. The second arm received a subcutaneous injection of PDG for six consecutive days in each cycle of treatment. The side effects of GCF treatment and its effect on blood parameters were compared in each cycle and during eight cycles of chemotherapy.

RESULTS

Hematologic parameters showed no significant differences in any of the treatment courses between the two study groups. The comparison of WBC (p = 0.527), Hgb (p = 0.075), Platelet (p = 0.819), Neutrophil (p = 0.575), Lymphocyte (p = 705) and ANC (p = 0.675) changes during the eight courses of treatment also revealed no statistically significant difference between the two study groups. Side effects including headache, injection site reaction and muscle pain had a lower frequency in patients receiving PDL drugs.

CONCLUSION

It seems that PDL is non-inferior in efficacy and also less toxic than PDG. Since PDL can be administered in a single dose and is also less costly, it can be regarded as a cost-effective drug for the treatment of chemotherapy-induced neutropenia.

TRIAL REGISTRATION

IRCT20190504043465N1 , May 2019.

摘要

背景

本研究旨在比较乳腺癌患者化疗过程中单剂(培非格司亭或 PDL)或重复 6 天每日注射(非格司亭或 PDG)的疗效和副作用,这是一项非劣效性临床试验。

方法

在这项随机临床试验中,招募了 80 名患者,并将其随机分为两组。一组在每个周期的化疗后第二天给予单次皮下注射 PDL。第二组在每个治疗周期的连续 6 天内给予皮下注射 PDG。比较每个周期和 8 个化疗周期中 GCF 治疗的副作用及其对血液参数的影响。

结果

在两组研究中,任何治疗方案中血液参数均无显著差异。白细胞计数(WBC)(p=0.527)、血红蛋白(Hgb)(p=0.075)、血小板(p=0.819)、中性粒细胞(p=0.575)、淋巴细胞(p=705)和 ANC(p=0.675)在 8 个疗程中的变化也没有统计学差异。接受 PDL 药物治疗的患者中,头痛、注射部位反应和肌肉疼痛等副作用的发生率较低。

结论

PDL 在疗效上不劣于 PDG,且毒性也较低。由于 PDL 可以单次给药,且成本较低,因此可以认为是治疗化疗引起的中性粒细胞减少症的一种具有成本效益的药物。

试验注册

IRCT20190504043465N1,2019 年 5 月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5e8/8066442/06f828f04b29/12885_2021_8197_Fig1_HTML.jpg

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