Aapro, M., Bokemeyer, C., Ludwig, H., Gascon, P., Boccadoro, M., Denhaerynck, K., . . . Abraham, I. (2016). Chemotherapy-induced (febrile) neutropenia prophylaxis with biosimilar filgrastim in elderly versus non-elderly cancer patients: Patterns, outcomes, and determinants (MONITOR-GCSF study). Journal of Geriatric Oncology. Advance online publication.

DOI Link

Study Purpose

To determine if the granulocyte–colony-stimulating factor (G-CSF) biosimilar filgrastim had similar outcomes for adults and older adult patients actively undergoing treatment for cancer

Intervention Characteristics/Basic Study Process

This was a prospective observational study of patients prescribed biosimilar filgrastim in 140 centers in 12 European countries.

Sample Characteristics

  • N = 1,447 patients; 41% were older than age 65 years (cut-off at age 65 years) and put into the older adult category   
  • AGE = Adults aged 18 years or older
  • MALES: 49.8% older adult, 31% adult
  • FEMALES: 50.2% older adult, 69% adult
  • CURRENT TREATMENT: Chemotherapy
  • KEY DISEASE CHARACTERISTICS: Stage III–IV breast, ovarian, bladder, and lung cancer; metastatic prostate cancer as well as stage III–IV large B-cell lymphoma and multiple myeloma

Setting

  • SITE: Multi-site   
  • SETTING TYPE: Not specified    
  • LOCATION: 12 European countries

Phase of Care and Clinical Applications

  • PHASE OF CARE:  Active antitumor treatment
  • APPLICATIONS: Elder care

Study Design

Prospective observational

Measurement Instruments/Methods

Comparative analysis of various components outlined by the authors

Results

No statistically significant differences existed in the rates of chemotherapy-induced neutropenia and febrile neutropenia episodes between either groups. G-CSF support is equally important in both groups. Older adult patients with underlying chronic conditions may be at higher risk for febrile neutropenia; in both groups, it is important to provide timely prophylaxis.

Conclusions

Timely G-CSF support is important in both older adult and adult patients receiving myelotoxic chemotherapy.

Nursing Implications

Nurses need to be aware of G-CSF administration for patients after chemotherapy. Independent of age group, it is important that patients receiving specific regimens get timely G-CSF treatment to prevent neutropenia duration.