Strategies for premedication and G-CSF application in sacituzumab govitecan treatment of patients with triple-negative breast cancer: multicenter insights.

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Małgorzata Pieniążek, Anna Polakiewicz-Gilowska, Marcin Kubeczko, Manuela Las-Jankowska, Renata Pacholczak-Madej, Paulina Kilian-Van Miegem, Marek Ziobro, Aleksandra Łacko, Michał Jarząb, Miroslawa Püsküllüoğlu
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Abstract

Background: Sacituzumab govitecan (SG) is approved for advanced triple-negative breast cancer (TNBC) in the second-line setting and beyond, offering improved survival compared to chemotherapy. Adverse events (AEs) commonly include myelosuppression, gastrointestinal disturbances, and hepatic toxicity. Effective premedication and prophylaxis are critical for AE management. This study assessed premedication protocols for SG-treated TNBC patients.

Materials and methods: A retrospective cohort study across five oncology centers in Poland analyzed premedication regimens for patients completing SG treatment by October 2024. Premedication evaluated included acetaminophen, corticosteroids, antihistamines, 5-HT3 and NK1 receptor antagonists, and granulocyte colony-stimulating factor (G-CSF) when needed. AEs were assessed using National Cancer Institute-Common Terminology Criteria for Adverse Events, version 5.0.

Results: Among 67 patients with TNBC who finished their treatment with SG, the mean age at SG initiation was 51.5 ± 12.4 years. Premedication in the first cycle included corticosteroids and 5-HT3 receptor antagonists in 66 (99%) and 65 (97%) patients, respectively; acetaminophen in 57 patients (85%), H1 blockers in 53 patients (79%), and H2 blockers in 52 patients (78%). G-CSF was used as primary prophylaxis in 27 patients (40%) and required in 53 patients (79%) during treatment. Atropine premedication was needed in 4 patients (6%) for grade 3 diarrhea as secondary prophylaxis.

Conclusions: Most patients received standardized premedication regimens, but significant variability was observed in G-CSF use for neutropenia prophylaxis. Only 6% of patients required atropine as diarrhea premedication. Practices regarding the use of G-CSF varied across centers, reflecting evolving SmPC guidance and individual risk-based approaches to neutropenia management.

sacituzumab govitecan治疗三阴性乳腺癌患者的用药前和G-CSF应用策略:多中心见解
背景:Sacituzumab govitecan (SG)被批准用于二线及以上的晚期三阴性乳腺癌(TNBC),与化疗相比可提高生存率。不良事件(ae)通常包括骨髓抑制、胃肠道紊乱和肝毒性。有效的预用药和预防是AE管理的关键。本研究评估了sg治疗的TNBC患者的用药前方案。材料和方法:波兰五个肿瘤中心的回顾性队列研究分析了2024年10月前完成SG治疗的患者的用药前方案。用药前评估包括对乙酰氨基酚、皮质类固醇、抗组胺药、5-HT3和NK1受体拮抗剂,必要时使用粒细胞集落刺激因子(G-CSF)。使用美国国家癌症研究所不良事件通用术语标准5.0版对ae进行评估。结果:在67例完成SG治疗的TNBC患者中,SG开始时的平均年龄为51.5±12.4岁。第一个周期的预用药包括皮质类固醇和5-HT3受体拮抗剂,分别有66例(99%)和65例(97%)患者;对乙酰氨基酚57例(85%),H1阻滞剂53例(79%),H2阻滞剂52例(78%)。在治疗期间,27例(40%)患者使用G-CSF作为初级预防措施,53例(79%)患者需要使用G-CSF。4例(6%)3级腹泻患者需要阿托品作为二级预防。结论:大多数患者接受了标准化的用药前方案,但G-CSF用于预防中性粒细胞减少的情况存在显著差异。只有6%的患者需要阿托品作为腹泻前用药。各中心使用G-CSF的做法各不相同,反映了SmPC指导和基于个体风险的中性粒细胞减少症管理方法的发展。
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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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