Efficacy of GM-CSF vs G-CSF in reducing chemotherapy-induced complications (CIC): A systematic review of literature

Abstract

6140 Background: While GM-CSF, a multilineage factor, activates neutrophils, eosinophils and monocyte/macrophages, G-CSF, a lineage-specific factor, regulates neutrophil production. GM-CSF is not approved for reducing CIC such as febrile neutropenia (FN); however, a number of studies have been published in this setting. We conducted a systematic literature review to evaluate the efficacy of GM-CSF vs G-CSF.Methods: MEDLINE databases were systematically reviewed for articles published between 01/87–02/03 containing search terms GM-CSF, neutropenia, and G-CSF among others. Two reviewers conducted the review and inter-rater reliability was calculated. Results: Nine solid tumor/lymphoma studies were accepted (inter-rater reliability 0.7). GM-CSF was compared with placebo in 6 RCTs and with G-CSF in 3 studies (see table). Conclusions: Head-to-head comparative trials of G-CSF and GM-CSF in reducing CIC are lacking. Identified GM-CSF studies did not show significant reduction in FN and fever. GM-CSF's multilineage nature limits its role in this clinical setting. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Amgen, Inc. Amgen, Inc. Amgen, Inc.