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- Title
Evaluation of Same-Day Versus Next-Day Administration of Pegfilgrastim in Patients With Breast Cancer.
- Authors
Weise Jr., Michael P.; Cascone, Vincent; Huong Tran; Martin, Grace; Mahmoudjafari, Zahra; Guangyi Gao; Khan, Qamar
- Abstract
BACKGROUND: Pegfilgrastim is a colony-stimulating factor used 24 to 72 hours after myelosuppressive chemotherapy to decrease the incidence of febrile neutropenia. Returning for treatment the day after chemotherapy for this injection is not always feasible or convenient for patients, and therefore, a same-day administration strategy may be preferred. Although there is an on-body injector available, the potential for mechanism failures and the cost of a brand-name drug limit its potential use. Studies examining the same-day administration of pegfilgrastim have varied in their design, and there is minimal evidence for this administration strategy in patients with breast cancer. OBJECTIVE: To compare the outcome of same-day versus next-day administration of pegfilgrastim on a composite of neutropenia-related events (NREs) in patients with breast cancer. METHODS: This retrospective, single-center, matched-cohort chart review included patients with breast cancer who completed at least 1 cycle of curative-intent chemotherapy between January 1, 2019, and October 31, 2020, at The University of Kansas Health System. The patients were matched by chemotherapy regimen and age in a 2:1 ratio for next-day and same-day administration of pegfilgrastim. The primary composite outcome of NREs was defined as having at least 1 of the following events: chemotherapy cycle delayed because of neutropenia, a dose reduction in chemotherapy as a result of neutropenia, the cancellation of planned chemotherapy cycles secondary to neutropenia, and admission to the hospital with a suspected or confirmed diagnosis of febrile neutropenia. RESULTS: A total of 87 patients were included in this study for data analysis and matching, including 58 patients who received the next-day administration of pegfilgrastim and 29 patients who received the same-day administration of pegfilgrastim. There were 6 patients who met the composite outcome in the next-day (10.3%) and same-day (20.7%) pegfilgrastim administration groups (odds ratio, 0.36; 95% confidence interval, 0.08-1.41). In all, 8 separate events occurred in the same-day pegfilgrastim group and 11 separate events occurred in the next-day pegfilgrastim group. The most frequent NRE was hospital admission for suspected or confirmed febrile neutropenia. In all, chemotherapy was cancelled for 2 cycles in the same-day pegfilgrastim cohort versus for 4 cycles in the next-day pegfilgrastim cohort. There were no cases of COVID-19 or treatment-related deaths in either group. CONCLUSION: Although the use of same-day pegfilgrastim did not significantly increase NREs and is not overtly detrimental to the patient, same-day pegfilgrastim cannot be recommended for routine use based on the results of this study. Larger, interventional studies are needed to validate this study's results to expand the use of same-day pegfilgrastim.
- Publication
Journal of Hematology Oncology Pharmacy, 2023, Vol 13, Issue 5, p241
- ISSN
2164-1153
- Publication type
Academic Journal