Filgrastim prophylaxis in elderly cancer patients in the real-life setting: a French multicenter observational study, the TULIP study

• Published in: Supportive care in cancer Vol. 27; no. 11; pp. 4283 - 4292
• Main Authors: Laribi, Kamel, Badinand, Delphine, Janoray, Philippe, Benabed, Khaled, Mouysset, Jean-Loup, Fabre, Elizabeth, Monchecourt, Françoise, Diab, Rafik
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2019; Springer; Springer Nature B.V
• Subjects: Aged; Aged patients; Cancer; Cancer patients; Chemotherapy; Clinical trials; Drug therapy; Female; Filgrastim - pharmacology; Filgrastim - therapeutic use; Granulocyte colony-stimulating factor; Hematologic Agents - pharmacology; Hematologic Agents - therapeutic use; Humans; Male; Medicine; Medicine & Public Health; Neoplasms - drug therapy; Neutropenia; Neutropenia - chemically induced; Nursing; Nursing Research; Observational studies; Older people; Oncology; Oncology, Experimental; Original; Original Article; Pain Medicine; Practice; Prevention; Rehabilitation Medicine; Side effects; France; Chemotherapy-induced neutropenia; Primary prophylaxis; Secondary prophylaxis; Elderly patients; Filgrastim
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-019-04725-0

Purpose Few studies are currently available among elderly patients, justifying the need for better understanding of daily medical practices in terms of use of growth factors to prevent chemotherapy (CT)-induced neutropenia. The primary objective of this study was to describe the use of filgrastim in the elderly. Methods Cancer patients aged 65 years and above, undergoing CT and initiating a prophylactic treatment with filgrastim, were enrolled. Patients were followed according to routine medical practice from filgrastim initiation until the end of the CT or after a maximum of 6 cycles. Results One thousand one hundred nineteen evaluable patients were documented in the study (mean age 73.9 ± 6.2 years, 52.1% men). The majority were suffering from solid tumor (73%) with ECOG 0–1 for 80% of them. Approximately two-third had a global risk for FN ≥ 20%, and one third < 20%. Through all CT cycles, no differences were observed between age classes ([65–74], [75–85], or > 85) in dose, duration, and time to first injection from CT start. Most patients (84%) received primary prophylaxis (PP) and 70% were administered during the first CT cycle. The median time from CT start until filgrastim was 4 days. The median duration of filgrastim treatment was 5 days. Dose reductions and CT delays were less frequent in patients receiving PP (4.8% and 7.1% respectively) than secondary prophylaxis (9.2% and 13.3% respectively). Conclusions Filgrastim use was consistent with French Market Authorization terms. No difference was shown compared with younger patients. Safety data were consistent with the known safety profile.