Filgrastim pegfilgrastim

Is the ANC on the way down (before nadir) or on the way up (after nadir) Was the patient receiving prophylactic antibiotics, prophylactic filgrastim, or sar-gramostim or received prophylactic pegfilgrastim ... 

Renwick W, Pettengell R, Green M (2009) Use of filgrastim and pegfilgrastim to support delivery of chemotherapy twenty years of clinical experience. BioDrugs 23 175-186... 

Filgrastim [G-CSF] (Neupogen) Oprelvekin (Neumega) Pegfilgrastim (Neulasta)... 

Neulasta (PEGfilgrastim, rPEGyl-ated filgrastim — see Neupogen). Also marketed in EU as Neupopeg... 

Pharmacokinetics The pharmacokinetics of pegfilgrastim were studied in 379 patients with cancer. The pegylated version of filgrastim demonstrated nonlinear pharmacokinetics, and clearance decreased with increases in dose. Neutrophil receptor binding is an important component of pegfilgrastim clearance, and serum clearance is directly related to the number of neu-... 

Pegfilgrastim Long-acting form of filgrastim that is covalently linked to a type of polyethylene glycol ... 

Dose-ranging PK and PD studies of pegfilgrastim have been conducted in mice, rats, and monkeys. Similar to filgrastim, the PK of pegfilgrastim are nonlinear after SC administration the clearance of pegfilgrastim decreases with increasing... 

Fig. 15.1 Structure of pegfilgrastim. A relatively compact protein (filgrastim) is shown at the top of this molecule model. Despite having a similar molecular weight to filgrastim (18.8 kDa), the PEG moiety (20 kDa), shown at the bottom, is loosely hydrated and occupies a relatively large volume. (Adapted with permission from [12]).

Fig. 15.3 Plasma concentrations of filgrastim (left) and pegfilgrastim (right), both given at 100 pg/kg in sham-operated rats (closed symbols) and bilateral nephrectomized rats (open symbols). (Adapted with permission from [25]).

Fig. 15.7 Median cytokine (pegfilgrastim or filgrastim) concentration-time profiles and median ANC-time profiles in patients with breast cancer. In cycle 1, n = 18, 59, and 44 for pegfilgrastim 30-, 60-, and 100-pg/kg cohorts, respectively, and n = 25 for the filgrastim cohort. In cycle 3, n = 4, 68, and 44 for pegfilgrastim 30-, 60-, and 100-pg/kg cohorts, respectively, and n = 25 for the filgrastim cohort. (Adapted with permission from [36]).

The modeled PK and ANC profiles suggested that the PK/PD model adequately described the relationship between pegfilgrastim concentrations and neutrophil response before and after chemotherapy in patients with NSCLC (Fig. 15.8). In this analysis, the linear, neutrophil-independent clearance pathway for pegfilgrastim was significantly reduced compared with that for filgrastim the predominant... 

Fig. 15.12 Mean (SE) duration of grade 4 neutropenia in patients with breast cancer during the first chemotherapy cycle. The responses for the different body weight subsets were similar after a single fixed dose of pegfilgrastim 6 mg and after daily doses of filgrastim 5 pg/kg. (Data from [41]).

Farese AM,Yang B-B, Roskos L, Stead RB, MacVittie TJ Pegfilgrastim, a sustained-duration form of filgrastim, significantly improves neutrophil recovery after autologous marrow transplantation in rhesus macaques. Bone Marrow Transplant. 2003 32 399-404. 

Holmes FA, Jones SE, O Shaughnessy J, et al. Comparable efficacy and safety profiles of once-per-cycle pegfilgrastim and daily injection filgrastim in chemotherapy-induced neutropenia a multicenter... 

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