Mechanism of action, efficacy and safety of long-acting granulocyte-colony stimulating factors (G-CSFs) in neutropenia associated with myelotoxic chemotherapy

Abstract

Granulocyte-colony stimulating factors (G-CSFs) have been used in the prevention and treatment of severe neutropenia associated with myelotoxic chemotherapy since 1990s. In the recent years, long-active recombinant G-CSFs — pegfilgrastim and lipegfilgrastim — were introduced. The review of available literature data suggests that the long-acting recombinant G-CSFs are characterized by a favorable pharmacokinetic profile after administration at a single dose of 6 mg per cytotoxic chemotherapy cycle. Clinical trials showed that the efficacy of both agents administered at the single dose is comparable to that of short-acting human recombinant G-CSF, filgrastim, injected daily after the course of chemotherapy. Both, the above mentioned evidence and satisfactory adverse event profile of the long-acting recombinant G-CSFs suggest that these agents should be routinely used in all patients at risk of severe neutropenia related to myelosupressive chemotherapy.