Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study

Introduction: This study aimed to assess the impact of prophylactic use of PEG-rhG-CSF on first-line immunochemotherapy in advanced NSCLC. Methods: A cohort of patients with advanced NSCLC who received first-line immunochemotherapy at Shengjing Hospital of China Medical University between January 20...

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Main Authors: Li Sun, MD, Yuan Tian, MD, Shuling Zhang, MD, PhD, Letian Huang, MD, Jietao Ma, MD, PhD, Chengbo Han, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:JTO Clinical and Research Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666364324001504
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author Li Sun, MD
Yuan Tian, MD
Shuling Zhang, MD, PhD
Letian Huang, MD
Jietao Ma, MD, PhD
Chengbo Han, MD, PhD
author_facet Li Sun, MD
Yuan Tian, MD
Shuling Zhang, MD, PhD
Letian Huang, MD
Jietao Ma, MD, PhD
Chengbo Han, MD, PhD
author_sort Li Sun, MD
collection DOAJ
description Introduction: This study aimed to assess the impact of prophylactic use of PEG-rhG-CSF on first-line immunochemotherapy in advanced NSCLC. Methods: A cohort of patients with advanced NSCLC who received first-line immunochemotherapy at Shengjing Hospital of China Medical University between January 2019 and July 2024 was selected for this study. Patients were divided into the following two groups: a treatment group that received prophylactic PEG-rhG-CSF (≥1 cycle) 48 hours after immunochemotherapy and a control group that did not receive PEG-rhG-CSF. The primary end points were progression-free survival (PFS), overall survival (OS), overall response rate, and safety. A propensity score-matched analysis was performed to reduce potential confounders. Results: A total of 220 patients were enrolled, with 87 in the treatment group and 133 in the control group. Median PFS was 10.5 months in both the treatment and control groups (p = 0.86), and median OS was 33.9 months in the treatment group versus not reached in the control group (p = 0.71). The overall response rate was 64.4% in the treatment group and 58.6% in the control group (p = 0.40). After propensity score-matched analysis (each group included 78 patients), median PFS was 12.6 months in the treatment group versus 10.5 months in the control group (p = 0.99), and median OS remained 30.3 months in the treatment group versus not reached in the control group (p = 0.85). The treatment group had a reduced incidence of chemotherapy interruptions, any grade of leukopenia, any grade of neutropenia, and grades 3 to 5 neutropenia, without an increase in immune-related adverse events. Conclusions: The prophylactic use of PEG-rhG-CSF in patients with advanced NSCLC undergoing first-line immunochemotherapy did not compromise efficacy and safety. It reduced chemotherapy interruptions and neutropenia, without increasing immune-related adverse events, thus supporting safe and uninterrupted treatment.
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spelling doaj-art-d47f839d8a21498daace73440cbea71a2025-01-12T05:25:48ZengElsevierJTO Clinical and Research Reports2666-36432025-02-0162100780Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort StudyLi Sun, MD0Yuan Tian, MD1Shuling Zhang, MD, PhD2Letian Huang, MD3Jietao Ma, MD, PhD4Chengbo Han, MD, PhD5Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of ChinaDepartment of Oncology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of ChinaCorresponding author. Address for correspondence: Chengbo Han, MD, PhD, Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110022, People's Republic of China.; Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of ChinaIntroduction: This study aimed to assess the impact of prophylactic use of PEG-rhG-CSF on first-line immunochemotherapy in advanced NSCLC. Methods: A cohort of patients with advanced NSCLC who received first-line immunochemotherapy at Shengjing Hospital of China Medical University between January 2019 and July 2024 was selected for this study. Patients were divided into the following two groups: a treatment group that received prophylactic PEG-rhG-CSF (≥1 cycle) 48 hours after immunochemotherapy and a control group that did not receive PEG-rhG-CSF. The primary end points were progression-free survival (PFS), overall survival (OS), overall response rate, and safety. A propensity score-matched analysis was performed to reduce potential confounders. Results: A total of 220 patients were enrolled, with 87 in the treatment group and 133 in the control group. Median PFS was 10.5 months in both the treatment and control groups (p = 0.86), and median OS was 33.9 months in the treatment group versus not reached in the control group (p = 0.71). The overall response rate was 64.4% in the treatment group and 58.6% in the control group (p = 0.40). After propensity score-matched analysis (each group included 78 patients), median PFS was 12.6 months in the treatment group versus 10.5 months in the control group (p = 0.99), and median OS remained 30.3 months in the treatment group versus not reached in the control group (p = 0.85). The treatment group had a reduced incidence of chemotherapy interruptions, any grade of leukopenia, any grade of neutropenia, and grades 3 to 5 neutropenia, without an increase in immune-related adverse events. Conclusions: The prophylactic use of PEG-rhG-CSF in patients with advanced NSCLC undergoing first-line immunochemotherapy did not compromise efficacy and safety. It reduced chemotherapy interruptions and neutropenia, without increasing immune-related adverse events, thus supporting safe and uninterrupted treatment.http://www.sciencedirect.com/science/article/pii/S2666364324001504ImmunochemotherapyNon–small cell lung cancerPEG-rhG-CSFSafety
spellingShingle Li Sun, MD
Yuan Tian, MD
Shuling Zhang, MD, PhD
Letian Huang, MD
Jietao Ma, MD, PhD
Chengbo Han, MD, PhD
Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study
JTO Clinical and Research Reports
Immunochemotherapy
Non–small cell lung cancer
PEG-rhG-CSF
Safety
title Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study
title_full Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study
title_fullStr Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study
title_full_unstemmed Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study
title_short Impact of Prophylactic Use of PEG-rhG-CSF on First-Line Immunochemotherapy in Advanced NSCLC: A Cohort Study
title_sort impact of prophylactic use of peg rhg csf on first line immunochemotherapy in advanced nsclc a cohort study
topic Immunochemotherapy
Non–small cell lung cancer
PEG-rhG-CSF
Safety
url http://www.sciencedirect.com/science/article/pii/S2666364324001504
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