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首页> 外文期刊>Expert opinion on therapeutic targets >Optimized granulocyte colony-stimulating factor prophylaxis in adult cancer patients: from biological principles to clinical guidelines.
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Optimized granulocyte colony-stimulating factor prophylaxis in adult cancer patients: from biological principles to clinical guidelines.

机译：优化的成年癌症患者预防粒细胞集落刺激因子：从生物学原理到临床指导原则。

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INTRODUCTION: Chemotherapy-induced neutropenia, the depth and length of which are correlated to the risk of febrile neutropenia (FN) and neutropenia sepsis, remains a serious problem in medical oncology. Granulocyte colony-stimulating factors (G-CSF) stimulate the proliferation and survival of neutrophils and their precursors, thereby reducing the incidence, duration and severity of neutropenic events across a broad range of malignancies and regimens, often enabling the delivery of full chemotherapy dose intensity. AREAS COVERED: In this review, areas covered include the physiologic role of G-CSF in granulopoiesis, as well as a related biological model of bone marrow kinetics after chemotherapy. Information relating to the application of clinical guidelines for optimization of prophylaxis of FN in adult cancer patients was critically summarized. The literature and pharmacological data were obtained through an electronic search. EXPERT OPINION: There are relevant physiological and clinical evidences for the use of G-CSF to prevent FN and to ameliorate the myelotoxicities of cancer chemotherapy. In particular, biological models are in favor of the prophylactic rather than therapeutic use of G-CSF therapy. Use of a single dose of pegfilgrastim per cycle in appropriate patients provides a more convenient and potentially more effective strategy for assisting neutrophil recovery. While biosimilars may cost less, future developments in their regulation will need to address multiple issues. In the interim, physicians should remember that small differences in biochemical and biophysical characteristics might translate into differences in potency and immunogenic potential.
机译：引言：化疗引起的中性粒细胞减少症的深度和长度与高热性中性粒细胞减少症（FN）和中性粒细胞减少症败血症的风险相关，仍然是医学肿瘤学中的严重问题。粒细胞集落刺激因子（G-CSF）刺激嗜中性粒细胞及其前体的增殖和存活，从而降低了广泛范围的恶性肿瘤和治疗方案中性粒细胞减少事件的发生率，持续时间和严重程度，通常能够提供完整的化疗剂量强度。覆盖的区域：在这篇综述中，涉及的领域包括G-CSF在粒细胞生成中的生理作用，以及化疗后骨髓动力学的相关生物学模型。严格总结了有关在成人癌症患者中优化FN预防临床指南应用的信息。文献和药理数据是通过电子搜索获得的。专家意见：使用G-CSF预防FN并改善癌症化学疗法的骨髓毒性有相关的生理和临床证据。特别地，生物学模型有利于预防性而非治疗性使用G-CSF疗法。在适当的患者中，每个周期使用单剂量的吡格非司亭可为中性粒细胞的恢复提供更方便，潜在更有效的策略。虽然生物仿制药的成本可能更低，但其法规的未来发展将需要解决多个问题。在此期间，医生应记住，生化和生物物理特性的微小差异可能会转化为效价和免疫原性潜力的差异。

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