Leveraging G-CSF prescribing in the outpatient setting: considerations beyond clinical factors-a questionnaire study

Support Care Cancer. 2024 May 14;32(6):347. doi: 10.1007/s00520-024-08524-0.

Abstract

Purpose: This study aims to delineate G-CSF treatment practices, assess decision criteria, and measure their implementation in ambulatory settings for patients with breast (BC), lung (LC), or gastrointestinal cancers (GIC), beyond standard recommendations.

Methods: In this non-interventional, cross-sectional, multicenter study, clinical cases were presented using conversational interfaces (chatbots), simulating a conversation with one or more virtual interlocutors through voice or text exchange. The clinical simulations were configured by four parameters: types of cancer, risk of FN related to chemotherapy and comorbidities, access to care, and therapy setting (adjuvant/neoadjuvant/metastatic).

Results: The questionnaire was completed by 102 physicians. Most practitioners (84.5%) reported prescribing G-CSF, regardless of tumor type. G-CSF was prescribed more frequently for adjuvant/neoadjuvant therapy than for metastatic cases. The type of chemotherapy was cited as the first reason for prescribing G-CSF, with access to care being the second. Regarding the type of chemotherapy, physicians do not consider this factor alone, but combined with comorbidities and age (56.7% of cases). Pegfilgrastim long-acting was prescribed in most cases of BC and LC (70.1% and 86%, respectively), while filgrastim short-acting was named in the majority of cases of GIC (61.7%); 76.3% of physicians prescribed G-CSF as primary prophylaxis.

Conclusions: Our findings suggest that recommended practices are broadly followed. In the majority of cases, G-CSF is prescribed as primary prophylaxis. In addition, physicians seem more inclined to prescribe G-CSF to adjuvant/neoadjuvant patients rather than metastatic patients. Finally, the type of chemotherapy tends to be a more significant determining factor than the patient's background.

Keywords: Breast cancer; Chemotherapy; Febrile neutropenia; G-CSF; Gastrointestinal cancer; Lung cancer.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / methods
  • Breast Neoplasms / drug therapy
  • Cross-Sectional Studies
  • Female
  • Granulocyte Colony-Stimulating Factor* / administration & dosage
  • Granulocyte Colony-Stimulating Factor* / therapeutic use
  • Humans
  • Lung Neoplasms / drug therapy
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Outpatients / statistics & numerical data
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Surveys and Questionnaires