{Reference Type}: Journal Article
{Title}: 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.
{Author}: Ozaki Y;Yokoe T;Yoshinami T;Nozawa K;Nishio H;Tsuchihashi K;Ichihara E;Miura Y;Endo M;Yano S;Maruyama D;Susumu N;Takekuma M;Motohashi T;Ito M;Baba E;Ochi N;Kubo T;Uchino K;Kimura T;Kamiyama Y;Nakao S;Tamura S;Nishimoto H;Kato Y;Sato A;Takano T;
{Journal}: Int J Clin Oncol
{Volume}: 29
{Issue}: 5
{Year}: 2024 May 25
{Factor}: 3.85
{DOI}: 10.1007/s10147-024-02499-y
{Abstract}: <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.