Primary prophylaxis with G-CSF for patients with non-round cell soft tissue sarcomas: a systematic review for the Clinical Practice Guidelines for the Use of G-CSF 2022 of the Japan Society of Clinical Oncology

Int J Clin Oncol. 2024 Aug;29(8):1067-1073. doi: 10.1007/s10147-024-02569-1. Epub 2024 Jun 12.

Abstract

Background: Granulocyte colony-stimulating factor (G-CSF) is an essential supportive agent for chemotherapy-induced severe myelosuppression. We proposed two clinical questions (CQ): CQ #1, "Does primary prophylaxis with G-CSF benefit chemotherapy for non-round cell soft tissue sarcoma (NRC-STS)?" and CQ #2, "Does G-CSF-based intensified chemotherapy improve NRC-STS treatment outcomes?" for the Clinical Practice Guidelines for the Use of G-CSF 2022 of the Japan Society of Clinical Oncology.

Methods: A literature search was performed on the primary prophylactic use of G-CSF for NRC-STSs. Two reviewers assessed the extracted papers and analyzed overall survival, incidence of febrile neutropenia, infection-related mortality, quality of life, and pain.

Results: Eighty-one and 154 articles were extracted from the literature search for CQs #1 and #2, respectively. After the first and second screening, one and two articles were included in the final evaluation, respectively. Only some studies have addressed these two clinical questions through a literature review.

Conclusion: The clinical questions were converted to future research questions because of insufficient available data. The statements were proposed: "The benefit of primary G-CSF prophylaxis is not clear in NRC-STS" and "The benefit of intensified chemotherapy with primary G-CSF prophylaxis is not clear in NRC-STSs." G-CSF is often administered as primary prophylaxis when chemotherapy with severe myelosuppression is administered. However, its effectiveness and safety are yet to be scientifically proven.

Keywords: Adverse effects; Chemotherapy; Granulocyte colony-stimulating factor; Non-round cell sarcoma; Soft tissue sarcoma.

Publication types

  • Systematic Review

MeSH terms

  • Granulocyte Colony-Stimulating Factor* / therapeutic use
  • Humans
  • Japan
  • Medical Oncology
  • Practice Guidelines as Topic
  • Primary Prevention / methods
  • Quality of Life
  • Sarcoma* / drug therapy

Substances

  • Granulocyte Colony-Stimulating Factor