NCCN Guidelines Insights: Hematopoietic Growth Factors, Version 1.2020

Featured Updates to the NCCN Guidelines

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Pamela Sue Becker University of Washington/Seattle Cancer Care Alliance;

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Elizabeth A. Griffiths Roswell Park Comprehensive Cancer Center;

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Laura M. Alwan Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

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Kimo Bachiashvili O'Neal Comprehensive Cancer Center at UAB;

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Anna Brown University of Michigan Rogel Cancer Center;

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Rita Cool The University of Texas MD Anderson Cancer Center;

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Peter Curtin UC San Diego Moores Cancer Center;

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Shira Dinner Robert H. Lurie Comprehensive Cancer Center of Northwestern University;

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Ivana Gojo The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins;

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Ashley Hicks University of Wisconsin Carbone Cancer Center;

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Avyakta Kallam Fred & Pamela Buffett Cancer Center;

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Wajih Zaheer Kidwai Yale Cancer Center/Smilow Cancer Hospital;

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Dwight D. Kloth Fox Chase Cancer Center;

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Eric H. Kraut The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;

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Daniel Landsburg Abramson Cancer Center at the University of Pennsylvania;

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Gary H. Lyman Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

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Ryan Miller Vanderbilt-Ingram Cancer Center;

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Sudipto Mukherjee Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute;

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Shiven Patel Huntsman Cancer Institute at the University of Utah;

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Lia E. Perez Moffitt Cancer Center;

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Adam Poust University of Colorado Cancer Center;

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Raajit Rampal Memorial Sloan Kettering Cancer Center;

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Rachel Rosovsky Massachusetts General Hospital Cancer Center;

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Vivek Roy Mayo Clinic Cancer Center;

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Hope S. Rugo UCSF Helen Diller Family Comprehensive Cancer Center;

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Sepideh Shayani City of Hope National Medical Center;

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Sumithira Vasu The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;

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Martha Wadleigh Dana-Farber Cancer Institute;

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Kelly Westbrook Duke Cancer Center;

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Peter Westervelt Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine; and

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Jennifer Burns National Comprehensive Cancer Network.

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Jennifer Keller National Comprehensive Cancer Network.

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Lenora A. Pluchino National Comprehensive Cancer Network.

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Management of febrile neutropenia (FN) is an integral part of supportive care for patients undergoing cancer treatment. The NCCN Guidelines for Hematopoietic Growth Factors provide suggestions for appropriate evaluation, risk determination, prophylaxis, and management of FN. These NCCN Guidelines are intended to guide clinicians in the appropriate use of growth factors for select patients undergoing treatment of nonmyeloid malignancies. These NCCN Guidelines Insights highlight important updates to the NCCN Guidelines regarding the incorporation of newly FDA-approved granulocyte-colony stimulating factor biosimilars for the prevention and treatment of FN.

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    Zecchini J, Yum K, Steinberg A, et al.. A single-center, retrospective analysis to compare the efficacy and safety of filgrastim-sndz to filgrastim for prophylaxis of chemotherapy-induced neutropenia and for neutrophil recovery following autologous stem cell transplantation. Support Care Cancer 2018;26:10131016.

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    Schwartzberg LS, Lal LS, Balu S, et al.. Incidence of febrile neutropenia during chemotherapy among patients with nonmyeloid cancer receiving filgrastim vs a filgrastim biosimilar. Clinicoecon Outcomes Res 2018;10:493500.

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    Schwartzberg LS, Lal LS, Balu S, et al.. Clinical outcomes of treatment with filgrastim versus a filgrastim biosimilar and febrile neutropenia-associated costs among patients with nonmyeloid cancer undergoing chemotherapy. J Manag Care Spec Pharm 2018;24:976984.

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    Gatzemeier U, Ciuleanu T, Dediu M, et al.. XM02, the first biosimilar G-CSF, is safe and effective in reducing the duration of severe neutropenia and incidence of febrile neutropenia in patients with small cell or non-small cell lung cancer receiving platinum-based chemotherapy. J Thorac Oncol 2009;4:736740.

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    The Center for Biosimilars. FDA approves second Neupogen biosimilar, Nivestym. Available at: https://www.centerforbiosimilars.com/news/fda-approves-second-neupogen-biosimilar-nivestym. Accessed February 28, 2019.

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    Brito M, Esteves S, André R, et al.. Comparison of effectiveness of biosimilar filgrastim (Nivestim™), reference Amgen filgrastim and pegfilgrastim in febrile neutropenia primary prevention in breast cancer patients treated with neo(adjuvant) TAC: a non-interventional cohort study. Support Care Cancer 2016;24:597603.

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    O’Conner P, Tang H, Civoli F, et al.. Proposed pegfilgrastim biosimilar CHS-1701 demonstrates pharmacokinetic and pharmacodynamic similarity to marketed pegfilgrastim in a rat neutropenia model and in healthy subjects. Presented at the 22nd Congress of the European Hematology Association; June 22–25, 2017; Madrid, Spain. Abstract E1147.

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    U.S. Food & Drug Administration. FDA approves first biosimilar to Neulasta to help reduce the risk of infection during cancer treatment. Available at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm609805.htm. Accessed February 28, 2019.

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    The Center for Biosimilars. FDA approves Coherus' pegfilgrastim biosimilar, Udenyca. Available at: https://www.centerforbiosimilars.com/news/fda-approves-coherus-pegfilgrastim-biosimilar-udenyca. Accessed February 4, 2019.

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    Waller CF, Ranganna GM, Pennella EJ, et al.. Randomized phase 3 efficacy and safety trial of proposed pegfilgrastim biosimilar MYL-1401H in the prophylactic treatment of chemotherapy-induced neutropenia. Ann Hematol 2019;98:12171224.

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