Optimal use of granulocyte colony-stimulating factor prophylaxis to improve survival in cancer patients receiving treatment

BackgroundFebrile neutropenia (FN) is a relatively common complication of cytotoxic chemotherapy. Prophylaxis with granulocyte colony-stimulating factor (G-CSF) can prevent FN and chemotherapy dose delays and enable the use of the higher dose intensities associated with a survival benefit; however, G-CSF is not always used optimally.SummaryFive medical oncologists with a special interest in supportive care met to discuss the evidence for prophylaxis with G-CSF to improve survival in cancer patients, identify reasons why this is not always done, and suggest potential solutions. The dose intensity of chemotherapy is critical for maximizing survival in cancer patients but may be reduced as a result of hematological toxicity, such as FN. Use of G-CSF has been shown to increase the chances of achieving the planned dose intensity in various cancers, including early-stage breast cancer and non-Hodgkin lymphoma. All physicians treating cancer patients should consider the use of G-CSF prophylaxis in patients receiving chemotherapy, paying particular attention to patient-related risk factors.Key messagesStrategies to optimize G-CSF use include educating medical oncologists and pharmacists on the appropriate use of G-CSF and informing patients about the efficacy of G-CSF and its potential adverse effects. It is hoped that the evidence and opinions presented will help to encourage appropriate use of G-CSF to support cancer patients at risk of FN in achieving the best possible outcomes from chemotherapy.