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Novel agents to prevent chemotherapy-induced neutropenia and other myelosuppressive effects: revised evidence report
Novel agents to prevent chemotherapy-induced neutropenia and other myelosuppressive effects: revised evidence report
- Collection:
- Health Policy and Services Research
- Author(s):
- Tice, Jeffrey A., author
McKenna, Avery, author
Herce-Hagiwara, Belén, author
Moradi, Ashton, author
Pearson, Steven D., author
Ollendorf, Daniel A., author
Bloudek, Lisa, author
Carlson, Josh J., author - Contributor(s):
- California Technology Assessment Forum (Organization), issuing body.
Institute for Clinical and Economic Review, issuing body. - Publication:
- [Boston, Massachusetts] : Institute for Clinical and Economic Review, March 17, 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Antineoplastic Agents -- adverse effects
Chemotherapy-Induced Febrile Neutropenia -- drug therapy
Chemotherapy-Induced Febrile Neutropenia -- prevention & control
Neutropenia -- drug therapy
Neutropenia -- prevention & control
United States - Genre(s):
- Technical Report
- Abstract:
- Until recently, cytotoxic chemotherapy was the primary form of chemotherapy used to treat cancer, and it remains in widespread use today. Because it targets rapidly dividing cells, one of the common side effects of cytotoxic chemotherapy is low blood cell counts (myelosuppression), including low neutrophil counts (neutropenia), low platelet counts (thrombocytopenia), and low red blood cell counts (anemia). Neutropenia in particular puts patients at high risk for infection. When patients with severe neutropenia develop a fever (febrile neutropenia), they are frequently hospitalized and treated with broad spectrum antibiotics for presumed infections. In response to severe neutropenia, hematologists/oncologists may need to reduce the dose and/or frequency of chemotherapy. This can result in lower overall survival, particularly when chemotherapy is being used with the intent to cure the patient. Guidelines recommend that granulocyte colony stimulating factor (G-CSF) be routinely used to prevent neutropenia in patients at high risk for febrile neutropenia (>20%) or when risk is intermediate (10% to 20%) and patients have additional risk factors (age >65 years, prior CIN, poor functional status, poor nutritional status). The cost of hospitalizations for neutropenia is high. In the United States in 2012, there were over 100,000 hospitalizations for chemotherapy-associated neutropenia at a total cost of $2.7 billion. There are two new intravenous agents which may be used in place of or in conjunction with G-CSF. Trilaciclib is a cyclin-dependent kinase 4 and 6 inhibitor approved by the FDA on February 12, 2021, to decrease the incidence of myelosuppression in patients with extensive-stage small cell lung cancer (SCLC) undergoing certain chemotherapy treatments. Plinabulin, which received breakthrough designation from the FDA, is a selective immunomodulating microtubule-binding agent (SIMBA) for the prevention of CIN and possibly thrombocytopenia. On December 1, 2021, however, the FDA sent a complete response letter asking the company to perform a second trial documenting the benefits of plinabulin before approval could be considered.could be considered.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (various pagings))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918506285006676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918506285006676