G-CSF prophylaxis improves OS, but may predispose to secondary malignancy
medwireNews: An updated meta-analysis suggests that supportive granulocyte colony-stimulating factor (G-CSF) treatment during chemotherapy is associated with an improvement in overall survival (OS), but at the cost of an increased risk for secondary malignancies.
Andriy Krendyukov (Sandoz Biopharmaceuticals, Holzkirchen, Germany) and co-authors note that their results are in line with those of an earlier meta-analysis, except that in this case the association with secondary malignancy risk was statistically significant.
The current analysis included 68 studies, of which 14 had been published since the previous meta-analysis, and showed that the relative risk for mortality was a significant 8% lower for patients with solid tumors or malignant lymphoma who did versus did not receive G-CSF prophylaxis for chemotherapy-related neutropenic complications.
By contrast, the risk for secondary malignancy was nearly twofold higher with G-CSF support.
“Primary G-CSF support may enable administration of dose-dense, dose-escalation, and intensified chemotherapy regimens, leading to increased disease control and a consequent reduction in mortality, compared with no G-CSF support,” the researchers speculate.
However, they add that “[i]t was not possible to distinguish whether the risk of secondary malignancies is associated with supportive G-CSF use or the leukemogenic effects of intensified chemotherapeutic agents.”
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