Neulasta® - Chemotherapy Regimen Risk

Neulasta® (pefgilgrastim). Start with support

Chemotherapy

Regimen Risk

Use Neulasta^® beginning in the first cycle in regimens with 17% risk of febrile neutropenia

Regimen*	Neutropenia risk
Breast cancer	Grade 3–4 neutropenia risk	Febrile neutropenia risk	Reference (sample size)
AT Doxorubicin 50 mg/m² day 1, followed by docetaxel 75 mg/m² day 1. Repeat cycle every 21 days up to 8 cycles.	97%	33%	Nabholtz JM, et al. J Clin Oncol. 2003;21:968-975. (n = 213)
Docetaxel Docetaxel 100 mg/m² day 1. Repeat cycle every 21 days up to 4 cycles.	Not reported	17%	Vogel CL, et al. J Clin Oncol. 2005;23:1178-1184. (n = 465)
TAC Docetaxel 75 mg/m² day 1, doxorubicin 50 mg/m² day 1, cyclophosphamide 500 mg/m² day 1. Repeat cycle every 21 days for 6 cycles.	66%	25%	Martin M, et al. N Engl J Med. 2005;352:2302-2313. (n = 744)
Non-Hodgkin’s lymphoma	Grade 3–4 neutropenia risk	Febrile neutropenia risk	Reference (sample size)
CHOP Cyclophosphamide 750 mg/m² day 1, vincristine 1.4 mg/m² (max 2 mg) day 1, doxorubicin 50 mg/m² day 1, prednisone 50 mg/m² orally days 1-5. Repeat cycle every 21 days.	89% (Grade 4 granulocytopenia)	50% (Granulocytopenia)	Ösby E, et al. Blood. 2003;101:3840-3848. (n = 104)
CHOP+R Specifics not provided.	Not reported	37%	Ershler W, et al. Blood. 2005;106:152b. Abstract 4286. (n = 73)
ESHAP Etoposide 40 mg/m² days 1-4, methylprednisolone 250-500 mg days 1-5, cytarabine 2 g/m² day 5, cisplatin 25 mg/m² days 1-4. Repeat cycle every 21-28 days for 6-8 cycles.	Not reported	30%	Velasquez WS, et al. J Clin Oncol. 1994;12:1169-1176. (N = 122)
Non-small cell lung cancer	Grade 3–4 neutropenia risk	Febrile neutropenia risk	Reference (sample size)
Docetaxel/carboplatin Docetaxel 75 mg/m² day 1, followed by carboplatin targeted by Calvert equation to AUC of 6 day 1. Repeat cycle every 21 days up to 6 cycles.	73% (Grade 4)	26%	Millward MJ, et al. Ann Oncol. 2003;14:449-454. (N = 66)
GYN malignancies	Grade 3–4 neutropenia risk	Febrile neutropenia risk	Reference (sample size)
Paclitaxel/cisplatin Paclitaxel 135 mg/m² over 24 hours day 1, followed by cisplatin 75 mg/m² at a rate of 1 mg/min. Repeat cycle every 21 days.	61% (Grade 4)	28%	Rose PG, et al. J Clin Oncol. 1999;17:2676-2680. (n = 44)
Docetaxel Docetaxel 100 mg/m² day 1. Repeat cycle every 21 days.	75% (Grade 4)	30%	Rose PG, et al. Gynecol Oncol. 2003;88:130-135. (N = 60)
Topotecan Topotecan 1.5 mg/m² days 1-5. Repeat cycle every 21 days.	82% (Grade 4)	18%	Bookman MA, et al. J Clin Oncol. 1998;16:3345-3352. (N = 139)
Head & neck	Grade 3–4 neutropenia risk	Febrile neutropenia risk	Reference (sample size)
TIC Paclitaxel 175 mg/m² day 1, ifosfamide 1,000 mg/m² days 1-3 with 200 mg/m² mesna before and 400 mg/m² after ifosfamide on days 1-3. Followed by carboplatin targeted by Calvert equation to AUC of 6 day 1. Repeat cycle every 21-28 days.	92%	30%	Shin DM, et al. Cancer. 2001;91:1316-1323. (n = 54)
Sarcoma	Grade 3–4 neutropenia risk	Febrile neutropenia risk	Reference (sample size)
MAID Mesna 3 g/m² days 1-3, doxorubicin 20 mg/m² days 1-3, ifosfamide 2.5 g/m² days 1-3, dacarbazine 300 mg/m² days 1-3. Repeat cycle every 21 days up to 6 cycles.	Not reported	58% (First cycle)	Bui BN, et al. J Clin Oncol. 1995;13:2629-2636. (n = 26)

*G-CSF use not standardized.

Important: Neulasta^® is indicated in myelosuppressive chemotherapy regimens associated with a febrile neutropenia risk > 17%.

See Important Product Safety Information.


	Neulasta^® (pegfilgrastim) is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in patients with nonmyeloid malignancies receiving myelosuppressive anticancer drugs associated with a clinically significant incidence of febrile neutropenia. Important Product Safety Information Neulasta^® Prescribing Information \| NEUPOGEN^® (Filgrastim) Prescribing Information \| Medical Information Connection™ \| Site Map \| Amgen.com 2009 Amgen. All rights reserved. This site for use in U.S. only.