Comparison of the effects of pegylated granulocyte?colony stimulating factor and granulocyte?colony stimulating factor on cytopenia induced by dose?dense chemotherapy in breast cancer patients
Abstract
Background and Objective: Myelosuppression is one of the frequent side e?ects of chemotherapy in breast cancer patients. Granulocyte?colony stimulating factor (G?CSF) and pegylated G?CSF are used for the prevention of neutropenia after chemotherapy. Pegylated G?CSF has longer half?life of action and can be used as a single dose in comparison to G?CSF. Te aim of this study is to compare the grade of cytopenia and side e?ects between G?CSF and biosimilar pegylated G?CSF in breast cancer patients treated with dose?dense chemotherapy. Materials and Methods: In the cross?over clinical trial study, 24 women with breast cancer were randomly divided into two groups and treated with dose?dense chemotherapy. Te frst group was treated with single dose of 6 mg
biosimilar pegylated G?CSF 24 h after the frst course of chemotherapy and the second course was followed by 300 µg daily injection of G?CSF for 6 days. Te chemotherapy regimen was combination of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. Te second group was treated with G?CSF after the frst course and pegylated G?CSF after the second course. Cell blood count (CBC) and side e?ects were evaluated 1 and 2 weeks after both courses of chemotherapy. Results: In this study, no signifcant carryover e?ect and treatment e?ect about the CBC parameters was found between pegylated G?CSF and G?CSF. Patients who were treated with biosimilar pegylated G?CSF had signifcantly higher side e?ects such as bone pain (P = 0.09) and gastrointestinal e?ects (P = 0.005)
in comparison to G?CSF. Conclusion: G?CSF and biosimilar pegylated G?CSF are e?ective in reducing cytopenia in breast cancer patients treated with dose?dense chemotherapy, but side e?ects induced by pegylated G?CSF (Pegagen) are higher.
biosimilar pegylated G?CSF 24 h after the frst course of chemotherapy and the second course was followed by 300 µg daily injection of G?CSF for 6 days. Te chemotherapy regimen was combination of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. Te second group was treated with G?CSF after the frst course and pegylated G?CSF after the second course. Cell blood count (CBC) and side e?ects were evaluated 1 and 2 weeks after both courses of chemotherapy. Results: In this study, no signifcant carryover e?ect and treatment e?ect about the CBC parameters was found between pegylated G?CSF and G?CSF. Patients who were treated with biosimilar pegylated G?CSF had signifcantly higher side e?ects such as bone pain (P = 0.09) and gastrointestinal e?ects (P = 0.005)
in comparison to G?CSF. Conclusion: G?CSF and biosimilar pegylated G?CSF are e?ective in reducing cytopenia in breast cancer patients treated with dose?dense chemotherapy, but side e?ects induced by pegylated G?CSF (Pegagen) are higher.
Keywords
Breast cancer, granulocyte?colony stimulating factor, Pegagen