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Comparison between a single dose of PEG G-CSF and multiple doses of non-PEG G-CSF: a systematic review and meta-analysis from Clinical Practice Guidelines for the use of G-CSF 2022

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Abstract

Backgroud

Granulocyte colony-stimulating factor (G-CSF) is widely used for the primary prophylaxis of febrile neutropenia (FN). Two types of G-CSF are available in Japan, namely G-CSF chemically bound to polyethylene glycol (PEG G-CSF), which provides long-lasting effects with a single dose, and non-polyethylene glycol-bound G-CSF (non-PEG G-CSF), which must be sequentially administrated for several days.

Methods

This current study investigated the utility of these treatments for the primary prophylaxis of FN through a systematic review of the literature. A detailed literature search for related studies was performed using PubMed, Ichushi-Web, and the Cochrane Library. Data were independently extracted and assessed by two reviewers. A qualitative analysis or meta-analysis was conducted to evaluate six outcomes.

Results

Through the first and second screenings, 23 and 18 articles were extracted for qualitative synthesis and meta-analysis, respectively. The incidence of FN was significantly lower in the PEG G-CSF group than in the non-PEG G-CSF group with a strong quality/certainty of evidence. The differences in other outcomes, such as overall survival, infection-related mortality, the duration of neutropenia (less than 500/μL), quality of life, and pain, were not apparent.

Conclusions

A single dose of PEG G-CSF is strongly recommended over multiple-dose non-PEG G-CSF therapy for the primary prophylaxis of FN.

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Data availability

Data associated with this systematic review can be accessed from the corresponding author upon reasonable request.

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Acknowledgements

We are grateful to Mr. Naohiko Yamaguchi for his contribution to the initial literature search. We would also like to thank Ms. Natsuki Fukuda for their valuable comments and suggestions. We additionally thank Joe Barber Jr., PhD, from Edanz (www.edanz.com/ac) for editing a draft of this manuscript.

Funding

The present study did not receive any funding.

Author information

Authors and Affiliations

  1. Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Tetsuhiro Yoshinami

  2. Department of Center for Cancer Genomics and Advanced Therapeutics, Breast Oncology, Aichi Cancer Center Hospital, Aichi, Japan

    Kazuki Nozawa

  3. Department of Surgery, Keio University School of Medicine, Tokyo, Japan

    Takamichi Yokoe

  4. Department of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Yukinori Ozaki & Toshimi Takano

  5. Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan

    Hiroshi Nishio

  6. Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University, Fukuoka, Japan

    Kenji Tsuchihashi & Mamoru Ito

  7. Center for Clinical Oncology, Okayama University Hospital, Okayama, Japan

    Eiki Ichihara

  8. Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan

    Yuji Miura

  9. Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan

    Makoto Endo

  10. Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan

    Shingo Yano

  11. Department of Hematology Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Dai Maruyama

  12. Department of Obstetrics and Gynecology, International University of Health and Welfare Narita Hospital, Chiba, Japan

    Nobuyuki Susumu

  13. Deparment of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan

    Munetaka Takekuma

  14. Department of Obstetrics and Gynecology, Tokyo Women’s Medical University Hospital, Tokyo, Japan

    Takashi Motohashi

  15. Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Eishi Baba

  16. Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan

    Nobuaki Ochi

  17. Department of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan

    Toshio Kubo

  18. Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo, Japan

    Keita Uchino

  19. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan

    Takahiro Kimura

  20. Department of Clinical Oncology/Hematology, The Jikei University School of Medicine, Tokyo, Japan

    Yutaro Kamiyama

  21. Department of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan

    Shinji Nakao

  22. Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan

    Shinobu Tamura

  23. Department of Nursing, Okayama University Hospital, Okayama, Japan

    Hitomi Nishimoto

  24. Department of Drug Information, Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, Kanagawa, Japan

    Yasuhisa Kato

  25. Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan

    Atsushi Sato

Authors
  1. Tetsuhiro Yoshinami
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  2. Kazuki Nozawa
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  3. Takamichi Yokoe
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  4. Yukinori Ozaki
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  8. Yuji Miura
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  9. Makoto Endo
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  15. Mamoru Ito
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  16. Eishi Baba
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  25. Yasuhisa Kato
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  26. Atsushi Sato
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  27. Toshimi Takano
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Contributions

All authors contributed to the conception and design of the present study. The first draft of the manuscript was written by T.Y., and all authors commented on the previous version of the manuscript. All authors read and gave their final approval.

Corresponding author

Correspondence to Tetsuhiro Yoshinami.

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Conflict of interest

TE.Y. received honoraria from Kyowa-Kirin, Pfizer, Chugai, Eli Lilly, MSD, Astra Zeneca and Eisai. Y.O. received honoraria from Daiichi-Sankyo, Pfizer, Chugai, Lilly and Kyowa Kirin. K.T. received honoraria from Ono, Chugai, Taiho and Novartis. E.I. received honoraria from Eli Lilly, and research funding from MSD, Ono, Janssen Pharma and Takeda. Y.M. received honoraria from Ono, MSD, Takeda, Eisai and Bristol Myers Squibb, and research funding from MSD and Ono. S.Y. received research funding from Otsuka. D.M. received honoraria from Janssen, Nippon Shinyaku, Eisai, Mundipharma, Kyowa Kirin, Chugai, Zenyaku, MSD, SymBio, Sanofi, AbbVie, Takeda, Astra Zeneca and Bristol Myers Squibb, and research funding from Biopharma, Novartis, Kyowa Kirin, Ono, Chugai, Janssen, Takeda, Otsuka, Sanofi, Astellas, Bristol Myers Squibb, AbbVie, Eisai, MSD, Taiho and Astra Zeneca. T.M. received honoraria from Astra Zeneca, Chugai and Myriadgenetics. E.B. received honoraria from Chugai, and Daiichi-Sankyo, and research funding from Taiho and Chugai. T.KU. received honoraria from Chugai. T.KI. received honoraria from Sanofi. S.N. received honoraria from Kyowa Kirin. A.S. received honoraria and scholarship donation from Chugai and Taiho. T.T. received honoraria from Daiichi-Sankyo, Chugai and Eli Lilly. Other authors declare that there are no conflicts of interest associated with this manuscript.

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Yoshinami, T., Nozawa, K., Yokoe, T. et al. Comparison between a single dose of PEG G-CSF and multiple doses of non-PEG G-CSF: a systematic review and meta-analysis from Clinical Practice Guidelines for the use of G-CSF 2022. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02504-4

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