Colony-stimulating factors in the prevention of solid tumors induced by chemotherapy in patients with febrile neutropenia

• Published in: International journal of antimicrobial agents Vol. 10; no. 1; pp. 3 - 9
• Main Authors: FREYER, G, LIGNEAU, B, TRILLET-LENOIR, V
• Format: Journal Article
• Language: English
• Published: London Elsevier 01.04.1998; Amsterdam; New York, NY
• Subjects: Antineoplastic Agents - adverse effects; Biological and medical sciences; Clinical Trials as Topic; Drug toxicity and drugs side effects treatment; Fever; Granulocyte Colony-Stimulating Factor - adverse effects; Granulocyte Colony-Stimulating Factor - therapeutic use; Granulocyte-Macrophage Colony-Stimulating Factor - adverse effects; Granulocyte-Macrophage Colony-Stimulating Factor - therapeutic use; Humans; Medical sciences; Neutropenia - chemically induced; Neutropenia - prevention & control; Pharmacology. Drug treatments; Toxicity: blood; Antineoplastic agent; Human; Leukopenia; Toxicity; Cytokine; Hemopathy; Review; Biological activity; Cost benefit ratio; Chemotherapy; Granulocyte colony stimulating factor; Randomization; Treatment; Clinical trial; Granulocyte macrophage colony stimulating factor; Neutropenia
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/S0924-8579(98)00016-8

Haematologic toxicity and its most frequent complication, febrile neutropenia represents the main limiting factor to the use of anti-cancer chemotherapy. The recent availability of recombinant human colony stimulating factors offers a new opportunity to improve the tolerance of these treatments. Most randomized trials in various solid tumors have demonstrated the ability of granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor to significantly reduce the incidence of febrile neutropenia and related complications. Interestingly enough, these compounds are well tolerated and easy to administrate. However, since the increase in dose-intensity does not translate into any improved efficacy in terms of response rates or survival, the use of colony-stimulating factors has to be decided on the basis of cost-benefit considerations. Therefore, some scientific societies such as the American Association of Clinical Oncology in the US and the Anti-Cancer Centers Group in France have published recommendations for their use in routine oncology practice. We here discuss these guidelines on the basis of an overview of the literature.