Multiple Myeloma Coverage from Every Angle

Pegfilgrastim Versus Filgrastim for Heavily Pretreated Patients With Multiple Myeloma

By: Julia Fiederlein
Posted: Friday, October 23, 2020

Claudio Cerchione, MD, PhD, of the Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy, and colleagues conducted a study to determine whether a single subcutaneous injection of pegfilgrastim is as effective as daily injections of standard filgrastim in patients with heavily pretreated multiple myeloma who received pomalidomide/dexamethasone. The results were presented during the virtual edition of the 2020 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract MM-390).

“Pegfilgrastim…allows for once-per-cycle dosing,” the investigators commented. “In patients affected by heavily pretreated multiple myeloma treated with pomalidomide/dexamethasone, pegfilgrastim seems to reduce the incidence of severe neutropenia and infections.”

A total of 57 patients with heavily pretreated refractory multiple myeloma were administered pomalidomide/dexamethasone every 28 days. On day 8, they received a single subcutaneous injection of pegfilgrastim. Blood cell counts were performed once weekly. From day 8 to day 19, patients were treated with prophylactic oral chinolonic antibiotics and antifungal drugs. After the first cycle, filgrastim was administered if the neutrophil count was less than 1,500 x 109 cells/L. All patients were switched to prophylaxis with pegfilgrastim during the second course; on day 3, they received a single subcutaneous injection.

Neutrophil levels reached a low point after a median of 10.4 days. In this study population, the maximum duration of neutropenia was 8 days during treatment with pegfilgrastim; thus, there seemed to be a reduction in neutropenia-related infections. The median nadir neutrophil count, which was evaluated for at least three therapy courses, was 1.28 x 109 cells/L. Just four patients required three administrations of filgrastim. According to the investigators, pegfilgrastim was well tolerated; a mild fever and bone pain were the most frequently reported side effects (21.2%).

Disclosure: No information regarding conflicts of interest was provided.

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