Disadvantage of overuse of granulocyte-colony stimulating factors (G-CSF) in systematic anticancer treatment

Abstract

To overuse means to use something too much, usually in a way that is deleterious to health or to use something improperly. Both respective summaries of product characteristics and current recommendations prepared by various scientific societies support very wide usage of granulocyte-colony stimulating factors in primary prophylaxis of febrile neutropenia. Studies that evaluated common practice in usage of G-CSFs confirmed good agreement with recommendations. However, some indications for primary prophylaxis listed in current guidelines are controversial as the risk neutropenic fever seems to be overestimated. For example, EORTC guidelines indicate that the M-VAC regimen is associated with the risk of neutropenic fever as high as 26% and primary prophylaxis is mandatory. In a phase III trial that compared M-VAC with combination of cisplatin and gemcitabine it was only 14%. Thus, some changes in current guidelines seem to be warranted.