Prophylactic long-acting granulocyte-colony stimulating factors (G-CSF) in gynecologic malignancies: an oncologic expert statement

Wien Med Wochenschr. 2015 Oct;165(19-20):387-94. doi: 10.1007/s10354-015-0392-3. Epub 2015 Oct 15.


We reviewed the status of the use of the prophylactic long-acting granulocyte colony-stimulating factors (G-CSFs) pegfilgrastim and lipegfilgrastim in gynecologic malignancies. Long-acting G-CSFs should not be used in weekly regimens. Filgrastim is not indicated in patients with febrile and/or severe neutropenia after administration of long-acting G-CSF in the same cycle. One study has shown a moderate effect on febrile neutropenia of ciprofloxacin when co-administered with pegfilgrastim. There is broad evidence from meta-analyses that pegfilgrastim effectively reduces severe neutropenia. In parallel, its adverse effects have been studied extensively. All-cause mortality was significantly reduced by pegfilgrastim. The glycopegylated long-acting G-CSF, lipegfilgrastim has demonstrated antineutropenic efficacy similar to that of pegfilgrastimin in one breast cancer study. In another pivitol non-small cell lung cancer study, impaired survival was observed in the lipegfilgrastim group during the first 30 days of study. The European Medicines Agency claimed more profound safety data to be provided for lipegfilgrastim by 2017.

Keywords: Chemotherapy-induced neutropenia; Febrile neutropenia; Granulocyte colony-stimulating factors (G-CSF); Gynecologic cancer; Long-acting granulocyte colony stimulating factors.

Publication types

  • Review

MeSH terms

  • Cause of Death
  • Ciprofloxacin / therapeutic use
  • Contraindications
  • Delayed-Action Preparations
  • Disease Progression
  • Drug Therapy, Combination
  • Female
  • Filgrastim
  • Genital Neoplasms, Female / drug therapy*
  • Genital Neoplasms, Female / mortality
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy
  • Neutropenia / mortality
  • Polyethylene Glycols
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Survival Analysis


  • Delayed-Action Preparations
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Ciprofloxacin
  • Filgrastim