Analysis of the Safety of Pegfilgrastim Addition in Bleomycin, Etoposide, and Cisplatin Treatment Patients With Germ Cell Tumors.

Ryunosuke Nakagawa,Shohei Kawaguchi,Hiroshi Yaegashi,Takahiro Nohara,Suguru Kadomoto,Tomoyuki Makino,Hiroaki Iwamoto,Yoshifumi Kadono,Kazuyoshi Shigehara,Masashi Iijima,Atsushi Mizokami,Kouji Izumi

doi:10.3389/fonc.2021.770067

Abstract

It has been reported that chemotherapy drugs and granulocyte colony-stimulating factor (G-CSF) administered on the same day can aggravate neutropenia. In the present study, we investigated the safety of pegfilgrastim during bleomycin, etoposide, and cisplatin (BEP) therapy. This single-center retrospective study, including 137 cycles of BEP therapy for germ cell tumors between January 2008 and April 2021, investigated safety. Short-acting G-CSF was used for 84 cycles and pegfilgrastim was used for 53 cycles. In the pegfilgrastim group, neutrophil count at nadir was significantly higher than in the G-CSF group (median 1,650/μl and 680/μl, respectively). The incidence of grade 3–4 neutropenia was significantly higher and the duration longer in the G-CSF group. Also, there was no significant difference in the incidence of febrile neutropenia. In conclusion, concomitant use of pegfilgrastim during BEP therapy did not increase neutropenia and was effective in terms of safety.

Highlights

Bleomycin, etoposide, and cisplatin (BEP) chemotherapy has been positioned as the standard of care of initial treatment for advanced germ cell tumors (GCT)
The short granulocyte colony-stimulating factor (G-CSF) group had a total of 84 cycles and the pegfilgrastim group had 53 cycles (9 of the 53 cycles were combined with G-CSF)
There was no significant difference in the primary tumor, pathology, clinical stage, International Germ Cell Consensus Classification (IGCCC), or metastatic site between the two groups (Table 2)

Summary

Introduction

Etoposide, and cisplatin (BEP) chemotherapy has been positioned as the standard of care of initial treatment for advanced germ cell tumors (GCT). The incidence of Common Terminology Criteria for Adverse Events (CTCAE) grade 3–4 neutropenia is as high as 73% [1]. These adverse effects of BEP therapy are reported to worsen the prognosis by decreasing the dose intensity and prolonging the dosing interval [2]. The use of broad-spectrum antibiotics and prolonged hospitalization in the event of FN increases the cost of treatment and the burden on patients [3]. Treatment guidelines recommend the use of granulocyte colony-stimulating factor (G-CSF) prophylaxis to prevent FN in patients deemed to be at high and moderate risk of developing it when patient-related risk factors are added [4, 5]. The plasma clearance of the renal drug is

Methods

Results

Conclusion