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Febrile neutropenia (FN) is a common and serious complication of cytotoxic chemotherapy. It impairs the immune system, placing the cancer patient at risk of infection and is a key contributor to chemotherapy-associated morbidity and mortality. Factors including therapeutic regimen, tumour type and individual characteristics influence susceptibility to myelosuppression. Over the years, several granulocyte-colony stimulating factors (G-CSFs) have been developed for primary prophylaxis of FN including filgrastim, lenograstim and pegfilgrastim. These agents have demonstrated safety and efficacy in reducing FN in patients allowing for administration of optimal treatment and thereby improving clinical outcomes. They also support the use of dose-dense and dose-intense chemotherapy regimens found to be beneficial in some patients. Recently, the introduction of biosimilars of G-CSFs with proven comparability with the originator filgrastim has expanded the prophylactic therapies available. Effective use of these drugs by physicians early in the chemotherapy schedule may lead to fewer adverse events and improved survival. |
