Strategies for premedication and G-CSF application in sacituzumab govitecan treatment of patients with triple-negative breast cancer: multicenter insights.
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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引用次数: 0
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.
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.