%0 Journal Article
%T Optimal timing of prophylactic pegylated G-CSF after chemotherapy administration for patients with cancer: a systematic review and meta-analysis from Clinical Practice Guidelines for the use of G-CSF 2022.
%A Ozaki Y
%A Yokoe T
%A Yoshinami T
%A Nozawa K
%A Nishio H
%A Tsuchihashi K
%A Ichihara E
%A Miura Y
%A Endo M
%A Yano S
%A Maruyama D
%A Susumu N
%A Takekuma M
%A Motohashi T
%A Ito M
%A Baba E
%A Ochi N
%A Kubo T
%A Uchino K
%A Kimura T
%A Kamiyama Y
%A Nakao S
%A Tamura S
%A Nishimoto H
%A Kato Y
%A Sato A
%A Takano T
%J Int J Clin Oncol
%V 29
%N 5
%D 2024 May 25
%M 38526621
%F 3.85
%R 10.1007/s10147-024-02499-y
%X <B>BACKGROUND: </B>The timing of prophylactic pegylated granulocyte colony-stimulating factor (G-CSF) administration during cancer chemotherapy varies, with Day 2 and Days 3-5 being the most common schedules. Optimal timing remains uncertain, affecting efficacy and adverse events. This systematic review sought to evaluate the available evidence on the timing of prophylactic pegylated G-CSF administration.<BR><B>METHODS: </B>Based on the Minds Handbook for Clinical Practice Guideline Development, we searched the PubMed, Ichushi-Web, and Cochrane Library databases for literature published from January 1990 to December 2019. The inclusion criteria included studies among the adult population using pegfilgrastim. The search strategy focused on timing-related keywords. Two reviewers independently extracted and assessed the data.<BR><B>RESULTS: </B>Among 300 initial search results, only four articles met the inclusion criteria. A meta-analysis for febrile neutropenia incidence suggested a potential higher incidence when pegylated G-CSF was administered on Days 3-5 than on Day 2 (odds ratio: 1.27, 95% CI 0.66-2.46, p = 0.47), with a moderate certainty of evidence. No significant difference in overall survival or mortality due to infections was observed. The trend of severe adverse events was lower on Days 3-5, without statistical significance (odds ratio: 0.72, 95% CI 0.14-3.67, p = 0.69) and with a moderate certainty of evidence. Data on pain were inconclusive.<BR><B>CONCLUSIONS: </B>Both Day 2 and Days 3-5 were weakly recommended for pegylated G-CSF administration post-chemotherapy in patients with cancer. The limited evidence highlights the need for further research to refine recommendations.