FOLFIRINOX/mFOLFIRINOX 요법을 사용하는 췌장암 환자에서 Eflapegrastim과 Pegteograstim의 항암화학요법으로 인한 호중구감소증 예방 효과 비교
Comparison of Prophylactic Efficacy of Eflapegrastim and Pegteograstim for Chemotherapy-induced Neutropenia in Pancreatic Cancer Patients Receiving FOLFIRINOX/mFOLFIRINOX
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Background : Chemotherapy-induced neutropenia can result in dose reductions and chemotherapy schedule delays, heightening the risk of complications and increasing infection rates, hospitalization, and mortality. The use of FOLFIRINOX in treating pancreatic cancer patients poses a significant risk of moderate-to-severe neutropenia, necessitating preventive granulocyte colony-stimulating factor (G-CSF) use. However, insufficient research in Korea on eflapegrastim’s secondary preventive effects warrants a comparative study. This research aimed to assess and compare the secondary preventive impacts of eflapegrastim and pegteograstim on neutropenia in patients with pancreatic cancer undergoing FOLFIRINOX/mFOLFIRINOX treatment. Methods : A retrospective analysis was conducted on patients aged 19 and older who started FOLFIRINOX/mFOLFIRINOX treatment at a tertiary hospital from April 2021 to December 2022. Patients who received prophylactic eflapegrastim or pegteograstim for neutropenia were included. Electronic medical records were analyzed to compare the rates and occurrences of neutropenia between the two groups after the initiation of pegylated G-CSF. Results : The study involved 47 participants in the eflapegrastim group and 174 in the pegteograstim group. The pegteograstim group exhibited a significantly higher median number of chemotherapy cycles (14 cycles) compared to the eflapegrastim group (12 cycles) (p = 0.04). After initiating pegylated G-CSF, the eflapegrastim group had a lower incidence of grade 3 and 4 neutropenia (37.8%) compared to the pegteograstim group (64.3%) (p < 0.01). Conclusion : The study found significantly lower rates of grade 3 and 4 neutropenia in the eflapegrastim group than in the pegteograstim group. However, the retrospective nature and limited patient cohort of the study should be noted. The impact of differences in chemotherapy cycles between the two groups cannot be overlooked. Therefore, a larger prospective study is needed to confirm eflapegrastim’s secondary preventive effect on neutropenia.
Abstract
Background : Chemotherapy-induced neutropenia can result in dose reductions and chemotherapy schedule delays, heightening the risk of complications and increasing infection rates, hospitalization, and mortality. The use of FOLFIRINOX in treating pancreatic cancer patients poses a significant risk of moderate-to-severe neutropenia, necessitating preventive granulocyte colony-stimulating factor (G-CSF) use. However, insufficient research in Korea on eflapegrastim’s secondary preventive effects warrants a comparative study. This research aimed to assess and compare the secondary preventive impacts of eflapegrastim and pegteograstim on neutropenia in patients with pancreatic cancer undergoing FOLFIRINOX/mFOLFIRINOX treatment. Methods : A retrospective analysis was conducted on patients aged 19 and older who started FOLFIRINOX/mFOLFIRINOX treatment at a tertiary hospital from April 2021 to December 2022. Patients who received prophylactic eflapegrastim or pegteograstim for neutropenia were included. Electronic medical records were analyzed to compare the rates and occurrences of neutropenia between the two groups after the initiation of pegylated G-CSF. Results : The study involved 47 participants in the eflapegrastim group and 174 in the pegteograstim group. The pegteograstim group exhibited a significantly higher median number of chemotherapy cycles (14 cycles) compared to the eflapegrastim group (12 cycles) (p = 0.04). After initiating pegylated G-CSF, the eflapegrastim group had a lower incidence of grade 3 and 4 neutropenia (37.8%) compared to the pegteograstim group (64.3%) (p < 0.01). Conclusion : The study found significantly lower rates of grade 3 and 4 neutropenia in the eflapegrastim group than in the pegteograstim group. However, the retrospective nature and limited patient cohort of the study should be noted. The impact of differences in chemotherapy cycles between the two groups cannot be overlooked. Therefore, a larger prospective study is needed to confirm eflapegrastim’s secondary preventive effect on neutropenia.
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