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Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure
Febrile neutropenia (FN) is a serious complication of chemotherapy, which can cause significant morbidity and mortality, result in dose delays and reductions and, ultimately, reduce cancer survival. Over the past decade, the availability of biosimilar filgrastim (short-acting granulocyte colony-stim...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer International Publishing
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211191/ https://www.ncbi.nlm.nih.gov/pubmed/32232676 http://dx.doi.org/10.1007/s40259-020-00411-4 |
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author | Cornes, Paul Gascon, Pere Vulto, Arnold G. Aapro, Matti |
author_facet | Cornes, Paul Gascon, Pere Vulto, Arnold G. Aapro, Matti |
author_sort | Cornes, Paul |
collection | PubMed |
description | Febrile neutropenia (FN) is a serious complication of chemotherapy, which can cause significant morbidity and mortality, result in dose delays and reductions and, ultimately, reduce cancer survival. Over the past decade, the availability of biosimilar filgrastim (short-acting granulocyte colony-stimulating factor [G-CSF]) has transformed patient access, with clear evidence of clinical benefit at preventing FN at reduced costs. In 2019, seven biosimilar pegfilgrastims (long-acting G-CSFs) were licensed, creating optimal market conditions and choice for prescribers. FN affects up to 117 per 1000 cancer patients, with mortality rates in the range of 2–21%. By reducing FN incidence and improving chemotherapy relative dose intensity (RDI), G-CSF has been associated with a 3.2% absolute survival benefit. Guidelines recommend primary prophylaxis and that filgrastim be administered for 10–14 days, while pegfilgrastim is administered once per cycle. When taken according to the guidelines, pegfilgrastim and filgrastim are equally effective. However, in routine clinical practice, filgrastim is often under-dosed (< 7 days) and has been shown to be inferior to pegfilgrastim at reducing FN incidence, hospitalisations and maintaining RDI. Once-per-cycle administration with pegfilgrastim might also aid patient adherence. The introduction of biosimilar pegfilgrastim should instigate a rethink of neutropenia management. Biosimilar pegfilgrastim offers countries using biosimilar filgrastim opportunities to improve adherence and thus cancer survival, whilst offering economic benefits for countries using reference pegfilgrastim. These benefits can be realised in full if biosimilar pegfilgrastim becomes part of routine clinical practice supported by drug and therapeutic committees implementing guidelines with multidisciplinary support in the hospital. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40259-020-00411-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-7211191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-72111912020-05-13 Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure Cornes, Paul Gascon, Pere Vulto, Arnold G. Aapro, Matti BioDrugs Current Opinion Febrile neutropenia (FN) is a serious complication of chemotherapy, which can cause significant morbidity and mortality, result in dose delays and reductions and, ultimately, reduce cancer survival. Over the past decade, the availability of biosimilar filgrastim (short-acting granulocyte colony-stimulating factor [G-CSF]) has transformed patient access, with clear evidence of clinical benefit at preventing FN at reduced costs. In 2019, seven biosimilar pegfilgrastims (long-acting G-CSFs) were licensed, creating optimal market conditions and choice for prescribers. FN affects up to 117 per 1000 cancer patients, with mortality rates in the range of 2–21%. By reducing FN incidence and improving chemotherapy relative dose intensity (RDI), G-CSF has been associated with a 3.2% absolute survival benefit. Guidelines recommend primary prophylaxis and that filgrastim be administered for 10–14 days, while pegfilgrastim is administered once per cycle. When taken according to the guidelines, pegfilgrastim and filgrastim are equally effective. However, in routine clinical practice, filgrastim is often under-dosed (< 7 days) and has been shown to be inferior to pegfilgrastim at reducing FN incidence, hospitalisations and maintaining RDI. Once-per-cycle administration with pegfilgrastim might also aid patient adherence. The introduction of biosimilar pegfilgrastim should instigate a rethink of neutropenia management. Biosimilar pegfilgrastim offers countries using biosimilar filgrastim opportunities to improve adherence and thus cancer survival, whilst offering economic benefits for countries using reference pegfilgrastim. These benefits can be realised in full if biosimilar pegfilgrastim becomes part of routine clinical practice supported by drug and therapeutic committees implementing guidelines with multidisciplinary support in the hospital. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40259-020-00411-4) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-03-30 2020 /pmc/articles/PMC7211191/ /pubmed/32232676 http://dx.doi.org/10.1007/s40259-020-00411-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Current Opinion Cornes, Paul Gascon, Pere Vulto, Arnold G. Aapro, Matti Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure |
title | Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure |
title_full | Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure |
title_fullStr | Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure |
title_full_unstemmed | Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure |
title_short | Biosimilar Pegfilgrastim: Improving Access and Optimising Practice to Supportive Care that Enables Cure |
title_sort | biosimilar pegfilgrastim: improving access and optimising practice to supportive care that enables cure |
topic | Current Opinion |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211191/ https://www.ncbi.nlm.nih.gov/pubmed/32232676 http://dx.doi.org/10.1007/s40259-020-00411-4 |
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