The role of G-CSF in the prevention of cytostaticassociated adverse events during antitumor drug therapy

Abstract

In the middle of the last century, the discovery of a number of cytotoxic agents was an incredible achievement in the treatment of malignant tumors. However, their use was limited by adverse events, primarily the development of myelosuppression. The occurrence of neutropenia is associated with frequent and extremely dangerous events that do not allow timely initiation of a new cycle of therapy and increases risk of infectious complications. Over the years, many attempts have been made to develop optimal management tactics for patients receiving cytotoxic therapy, including antibiotic therapy, the use of nonspecific myelopoiesis modulators, and even blood transfusions. With the advent of granulocyte precursor maturation stimulators in 1983, the situation has improved greatly. Filgrastim and its bioanalogues, registered later, made it possible to reconsider approaches to the use of intensified chemotherapy regimens. It has become possible to control the incidence of neutropenia using only subcutaneous forms of granulocyte colony-stimulating factors (GCSF). The article presents a clinical observation of the use of filgrastim in neoadjuvant therapy of early breast cancer. Filgrastim not only helped to cope with the development of newly diagnosed febrile neutropenia, but during continued treatment it prevented the development of adverse events. The administration of GCSF allowed timely completion of treatment with a complete pathological response, providing the patient with better survival prognosis.