Managing Neutropenia in Patients With Soft Tissue Sarcomas

Using prophylaxis with biosimilar granulocyte colony-stimulating factor (G-CSF) can reduce the severity of neutropenia in patients with soft tissue sarcoma, according to a study published in Supportive Care in Cancer.

For both early and advanced settings in soft tissue sarcoma, anthracycline and ifosfamide-based chemotherapy is a widely used regimen, and prophylaxis with G-CSF is usually needed to reduce the severity of chemotherapy-induced neutropenia. Italian researchers set out to determine the efficacy and safety of using the biosimilar G-CSF filgrastim in these patients.

A total of 67 patients receiving biosimilar filgrastim (US: Zarxio; Europe: Zarzio), originator filgrastim (Granulokine, Neupogen), and lenograstim (Myelostim; not approved in the United States) as primary prophylaxis were analyzed. They received a total of 360 cycles of therapy and were analyzed retrospectively.

The researchers determined that biosimilar G-CSF was effective in preventing febrile neutropenia and reducing the need for hospitalization in patients with soft tissue sarcoma undergoing epirubicin and ifosfamide treatment. Febrile neutropenia occurred in 44% of patients on biosimilar filgrastim, 40% of patients on originator filgrastim, and 45.5% of patients in the lenograstim group.

Safety profiles across the 3 groups were similar. However, using biosimilar filgrastim achieved savings of €225.25 ($251.50) over originator filgrastim and €262 ($292.54) over lenograstim.

Biosimilar G-CSF “proved comparable to its reference products from both a clinical and cost-effective standpoint,” the authors concluded.