PMID- 35463210
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 2049-9469 (Electronic)
IS  - 2049-9450 (Print)
IS  - 2049-9450 (Linking)
VI  - 16
IP  - 5
DP  - 2022 May
TI  - Prophylactic use of pegfilgrastim enables the management of severe neutropenia 
      without dose delays in patients with metastatic colorectal cancer treated with 
      TAS-102 plus bevacizumab.
PG  - 103
LID - 10.3892/mco.2022.2536 [doi]
LID - 103
AB  - Combined treatment with bevacizumab and trifluridine/tipiracil (TAS-102) leads to 
      an increased chance of survival in patients with refractory metastatic colorectal 
      cancer (mCRC); however, this treatment is associated with an increased frequency 
      of severe neutropenia (number of neutrophils <1,000), which should ideally be 
      managed without dose delays. The present study provided a retrospective review of 
      35 patients with mCRC, and aimed to elucidate the benefits of prophylactic 
      pegfilgrastim for the treatment of severe neutropenia. Patients received TAS-102 
      (35 mg/m(2)) orally twice daily on days 1-5 and 8-12 of each 28-day treatment 
      cycle, along with intravenous bevacizumab (5 mg/kg) on days 1 and 15. Moreover, 
      the patients received 3.6 mg pegfilgrastim on day 15 of each cycle. The incidence 
      of adverse events (AEs), disease control rate (DCR), progression-free survival 
      (PFS) and overall survival (OS) were assessed. In the first and subsequent 
      cycles, 23 and 12 patients, respectively, received pegfilgrastim. The most common 
      AE experienced was grade 3/4 neutropenia (8 patients; 22.9%). Among these 8 
      patients, 6 (17.1%) and 3 (8.6%) exhibited neutropenia prior to receiving 
      pegfilgrastim or following discontinuation of pegfilgrastim administration, 
      respectively. Moreover, 1 individual among these 8 patients (2.9%) demonstrated 
      grade 3 neutropenia both prior to receiving pegfilgrastim and following 
      discontinuation of pegfilgrastim. A total of 2 patients (5.7%) exhibited grade 3 
      bone pain, which prevented sustainable administration of pegfilgrastim and 
      resulted in grade 3 neutropenia. Dose delays and dose reduction of TAS-102 due to 
      neutropenia were required in 5 (14.3%) and 2 (5.7%) patients, respectively, 
      during the treatment period. None of the patients exhibited severe neutropenia 
      during chemotherapy after pegfilgrastim administration, thereby preventing dose 
      delays and dose reduction of TAS-102. The relative dose intensity was 96.8% 
      (65.0-100.0%), and the DCR was 54.3%. The median PFS and median OS were 4.4 and 
      14.9 months, respectively. In conclusion, prophylactic pegfilgrastim may 
      facilitate the management of severe neutropenia without dose delays in patients 
      with mCRC treated with TAS-102 plus bevacizumab.
CI  - Copyright: (c) Tamaki et al.
FAU - Tamaki, Sawako
AU  - Tamaki S
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Ishikawa, Hideki
AU  - Ishikawa H
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Suzuki, Koichi
AU  - Suzuki K
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Kimura, Yasuaki
AU  - Kimura Y
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Maemoto, Ryo
AU  - Maemoto R
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Abe, Iku
AU  - Abe I
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Endo, Yuhei
AU  - Endo Y
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Kakizawa, Nao
AU  - Kakizawa N
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Watanabe, Fumiaki
AU  - Watanabe F
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Futsuhara, Kazushige
AU  - Futsuhara K
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Saito, Masaaki
AU  - Saito M
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Tsujinaka, Shingo
AU  - Tsujinaka S
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Miyakura, Yasuyuki
AU  - Miyakura Y
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
FAU - Rikiyama, Toshiki
AU  - Rikiyama T
AD  - Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama 
      330-8503, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220412
PL  - England
TA  - Mol Clin Oncol
JT  - Molecular and clinical oncology
JID - 101613422
PMC - PMC9022083
OTO - NOTNLM
OT  - TAS-102
OT  - bevacizumab
OT  - filgrastim
OT  - neutropenia
OT  - pegfilgrastim
COIS- The authors declare that they have no competing interests.
EDAT- 2022/04/26 06:00
MHDA- 2022/04/26 06:01
PMCR- 2022/04/12
CRDT- 2022/04/25 05:18
PHST- 2021/07/11 00:00 [received]
PHST- 2022/03/01 00:00 [accepted]
PHST- 2022/04/25 05:18 [entrez]
PHST- 2022/04/26 06:00 [pubmed]
PHST- 2022/04/26 06:01 [medline]
PHST- 2022/04/12 00:00 [pmc-release]
AID - MCO-16-5-02536 [pii]
AID - 10.3892/mco.2022.2536 [doi]
PST - ppublish
SO  - Mol Clin Oncol. 2022 May;16(5):103. doi: 10.3892/mco.2022.2536. Epub 2022 Apr 12.