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Background & Objective: Granulocyte Colony Stimulating Factor (G-CSF) is a glycoprotein, helps in producing cells from bone marrow. Pharmaceutical analogs of naturally occurring G-CSF are used in chemotherapy induced neutropenia to prevent infections and sepsis. This study compares the efficacy and safety of single fixed dose of pegfilgrastim (pegylated form of filgratim) versus daily administration of filgrastim in breast cancer patients Patients and Method: Patients (n=80) with confirmed diagnosis of breast cancer receiving chemotherapy regimen (cyclophosphamide+doxorubicin+paclitaxel) were randomised in 2 groups. One group received pegfilgrastim 6 mg subcutaneously & the other group received filgrastim 300 mcg consecutively for 3 days on day 2 of chemotherapy cycle.The primary end point was the occurrence of febrile neutropenia (neutrophil count <4000 and fever on same day or the day after).The secondary end points were duration of hospitalizations, intravenous (IV) antibiotics required for neutropenia, and episodes of anemia. Any adverse drug reaction (ADR) related to study drug were observed. Results: Forty patients were analysed in each group (176 cycles in group 1 & 197 cycles in group 2). Neutropenia developed in 5.6% & 11.6% (p<0.0423), mean duration of hospital stay were 3-4 days & 5-6 days, i.v antibiotic usage was4% & 7%. 25% of patients in group 1 and 29% in group 2 suffered from anemia and required blood transfusion respectively. Bone pain was the most common ADR found due to filgrastim. Conclusion: Single dose of pegfilgrastim were significantly better than 3 doses of filgrastim for reducing Neutropenia rate in breast cancer patients receiving chemotherapy.

Comparison of Pegfilgrastim with Filgrastim in Management of Chemotherapy Induced Neutropenia in Breast Cancer Patients