Same-Day Pegfilgrastim or PFG-cbqv Prophylaxis of Chemotherapy-Induced Neutropenia in Bendamustine plus Rituximab and CHOP±R Regimens in Patients with Lymphoma and CLL

2021 Year in Review - Biosimilars —December 30, 2021



Real-world outcomes from a retrospective, single-center study suggested that pegfilgrastim or its biosimilar pegfilgrastim-cbqv does not increase febrile neutropenia or delayed engraftment risk in patients with lymphoma and CLL and may be safe to use after administration of chemotherapy.

A retrospective, single-center experience and real-world outcomes of same-day and next-day administration of pegfilgrastim or its biosimilar pegfilgrastim-cbqv for prophylaxis of chemotherapy-induced neutropenia (CIN) in patients with lymphoma and chronic lymphocytic leukemia (CLL) treated with bendamustine plus rituximab (BR) and cyclophosphamide/doxorubicin/vincristine/prednisone with or without rituximab (CHOP±R) regimens were reported at the 2021 American Society of Clinical Oncology Annual Meeting.

A retrospective chart review identified patients with lymphoma or CLL treated with chemotherapy (CHOP±R or BR) and prophylactic pegfilgrastim or pegfilgrastim-cbqv (either same day or next day) from November 2013 through November 2020 at the University of Arizona Cancer Center. Based on timing of pegfilgrastim administration, 2 patient cohorts of same-day and next-day pegfilgrastim administration were analyzed. Primary outcomes were the incidence of febrile neutropenia (FN) across all chemotherapy cycles and after cycle 1, grade 3/4 CIN, hospitalizations, antibiotics administration, and chemotherapy dose reduction or delay. A secondary analysis was conducted to compare the incidence of FN in the current study versus that previously reported in published studies of same-day pegfilgrastim.

A total of 116 patients were included in the study; of these, 103 received same-day pegfilgrastim and 13 received next-day pegfilgrastim. For same-day versus next-day pegfilgrastim, the incidence of FN in the first cycle was 6% versus 8% (P >.05), FN across all cycles was 4% versus 5% (P >.05), grade 3/4 CIN was 11% versus 16% (P >.05), hospitalization was 8% versus 11% (P >.05), antibiotic administration was 6% versus 32% (P = .001), and the incidence of dose delays/reductions was 11% versus 5% (P >.05), respectively. Compared with published studies of same-day pegfilgrastim administration after chemotherapy, a lower incidence of FN in the first cycle (6% vs 19% vs 11%) and across all cycles (5% vs 9% vs 17%) was reported.

Based on these results, the authors concluded that pegfilgrastim or pegfilgrastim-cbqv does not increase FN or delayed-engraftment risk in patients with lymphoma and CLL, and may be safe to use after administration of chemotherapy.

Source: McBride A, AlRawashdh, Bartels T, et al. Evaluation of same day pegfilgrastim (PFG) or PFG-cbqv prophylaxis of chemotherapy induced (febrile) neutropenia (CIN/FN) in bendamustine plus rituximab (BR) and CHOP+/-R regimens in patients with lymphoma and chronic lymphocytic leukemia (CLL): real-world, single-center experience. J Clin Oncol. 2021;39(suppl_15):e19541.

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