Abstract

Background

Granulocyte colony-stimulating factor (G-CSF) is commonly administered to cancer patients undergoing myelosuppressive chemotherapy, especially when incidence rate of febrile neutropenia (FN) surpasses 20%. While primary prophylaxis with G-CSF has been proven effective in preventing FN in patients with cancer, there is limited evidence regarding its efficacy in specifically, lung cancer. Our systematic review focused on the efficacy of G-CSF primary prophylaxis in lung cancer.

Methods

We extracted studies on non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) using the PubMed, Ichushi Web, and Cochrane Library databases. Two reviewers assessed the extracted studies for each type of lung cancer and conducted quantitative and meta-analyses of preplanned outcomes, including overall survival, FN incidence, infection-related mortality, quality of life, and musculoskeletal pain.

Results

A limited number of studies were extracted: two on NSCLC and six on SCLC. A meta-analysis was not conducted owing to insufficient data on NSCLC. Two case–control studies explored the efficacy of primary prophylaxis with G-CSF in patients with NSCLC (on docetaxel and ramucirumab therapy) and indicated a lower FN frequency with G-CSF. For SCLC, meta-analysis of five studies showed no significant reduction in FN incidence, with an odds ratio of 0.38 (95% confidence interval 0.03–5.56, P = 0.48). Outcomes other than FN incidence could not be evaluated due to low data availability.

Conclusion

Limited data are available on G-CSF prophylaxis in lung cancer. Primary prophylaxis with G-CSF may be weakly recommended in Japanese patients with NSCLC undergoing docetaxel and ramucirumab combination therapy.

中文翻译：

---

G-CSF 肺癌一级预防的有效性和安全性：系统评价和荟萃分析，以制定 G-CSF 使用临床实践指南 2022

摘要

背景

粒细胞集落刺激因子（G-CSF）通常用于接受骨髓抑制化疗的癌症患者，特别是当发热性中性粒细胞减少症（FN）发生率超过20%时。虽然 G-CSF 一级预防已被证明可有效预防癌症患者的 FN，但其对肺癌的疗效证据有限。我们的系统评价重点关注 G-CSF 一级预防对肺癌的疗效。

方法

我们使用 PubMed、Ichushi Web 和 Cochrane Library 数据库提取了有关非小细胞肺癌 (NSCLC) 和小细胞肺癌 (SCLC) 的研究。两名评价者评估了每种类型肺癌的提取研究，并对预先计划的结果进行了定量和荟萃分析，包括总生存期、FN 发生率、感染相关死亡率、生活质量和肌肉骨骼疼痛。

结果

提取的研究数量有限：两项针对 NSCLC，六项针对 SCLC。由于 NSCLC 数据不足，未进行荟萃分析。两项病例对照研究探讨了 G-CSF 一级预防对 NSCLC 患者（采用多西他赛和雷莫芦单抗治疗）的疗效，并表明 G-CSF 的 FN 频率较低。对于 SCLC，五项研究的荟萃分析显示 FN 发生率没有显着降低，优势比为 0.38（95% 置信区间 0.03–5.56，P = 0.48）。由于数据可用性低，无法评估 FN 发生率以外的结果。

结论

G-CSF 预防肺癌的数据有限。对于接受多西他赛和雷莫芦单抗联合治疗的日本 NSCLC 患者，可能不推荐使用 G-CSF 进行一级预防。