Study on the real-life use of G-CSF in patients with lung cancer: Secondary data analysis from the French national cohorts KBP-2020-CPHG and ESCAP-2020-CPHG

BackgroundChemotherapy-induced neutropenia (CIN) remains one of the most common and serious complications in oncology. Granulocyte Colony Stimulating Factors (G-CSF) have proven efficacy in the prophylaxis and reduction of the incidence of CIN. We analyze the modalities of use of G-CSF in patients with Lung Cancer (LC) in real life.MethodsKBP-2020 is a real-life prospective and multicenter study in lung cancer carried out in French Non academic Public Hospitals (NPH), which included 8999 patients diagnosed with LC in 2020. ESCAP-2020 is an on-going ancillary study collecting all anti-cancer treatment with a follow-up of 5 years. G-CSF use was collected in the case report form (CRF), and the definition of CIN risk was based on EORTC guidelines criteria according to the chemotherapy regimen.ResultsThe secondary data analysis was performed on 4135 patients from the KBP-2020 cohort and showed that 26.9% patients (n=1112) received a G-CSF as primary or secondary prophylaxis. Based on the EORTC guidelines, 665 patients from the ESCAP-2020 cohort were at risk of CIN, respectively 38.7% (n=402) in the group with G-CSF use (G-CSF+) versus (vs) 9.5% (n=263) in the group without G-CSF use (G-CSF-). G-CSF use was more important in patients with SCLC (71%) vs NSCLC (39%) and as primary prophylaxis in SCLC 89.4% (n=314) vs adenocarcinoma 74.6% (n=150). In patients at risk of CIN, there were no significant difference in term of age, sex, smoking status, BMI and weight loss. However, we found a significant difference on the performance status (PS) which was worse in patients receiving G-CSF (p=0.043). We observed in the G-CSF+ group, a higher proportion of SCLC (78.4% vs 48.7%, p <0.0001) and more often a metastatic disease at diagnosis (61.7% vs 43.1%, p <0.0001). We also observed a better Overall Survival in the G-CSF- group vs G-CSF+ group probably explained by less severe patients.ConclusionsCIN prophylaxis by G-CSF is underused in real life in patients with LC at risk of febrile neutropenia compared to EORTC guidelines. This should lead to better awareness among pulmonologists or oncologists involved in the management of LC to strengthen CIN prophylaxis.Legal entity responsible for the studyChugai Pharma France.FundingChugai Pharma France.DisclosureD. Debieuvre: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Janssen, Sanofi-Winthrop, Amgen, Roche; Financial Interests, Personal, Invited Speaker: Takeda; Financial Interests, Personal, Coordinating PI: Pfizer; Financial Interests, Institutional, Funding: Roche, AstraZeneca, Janssen, MSD, Pfizer, BMS, Lilly, Boehringer Ingelheim, GSK, Chugai, Chiesi, Takeda, Bayer, Sanofi-Winthrop, Amgen, AbbVie. K. Menia: Financial Interests, Personal, Other: Chugai. All other authors have declared no conflicts of interest.