Pegfilgrastim administered 72 h postchemo lessens bone pain

Administrating pegfilgrastim 72 h after chemotherapy, compared with 24- and 48-h administration, results in reduced pegfilgrastim-induced bone pain (PIBP) and does not appear to increase the rates of neutropenia or febrile neutropenia (FN), reports a study.

A team of investigators performed a three-arm randomized controlled trial in a tertiary A-level hospital among 159 patients with stage I to III breast cancer who were naïve to chemotherapy. Participants were randomly assigned in a 1:1:1 ratio to the 24-, 48-, or 72-h group based on the timing of pegfilgrastim administration postchemotherapy.

The primary endpoint was the area under the curve (AUC) of the daily worst bone pain score (assessed using the “worst pain” question from the Brief Pain Inventory, a 0 to 10 numerical rating scale [NRS]) for 5 consecutive days in the first cycle of chemotherapy. The incidence of severe bone pain (>5 on the NRS), neutropenia, and FN served as the secondary endpoints.

For the first cycle, the mean AUC showed a significant decline from 12.74 and 14.20 in the 24- and 48-h groups, respectively, to 6.05 in the 72-h group (p<0.001 for all). The incidence of severe bone pain also decreased significantly from 58.5 percent and 66.0 percent in the 24- and 48-h groups, respectively, to 22.6 percent in the 72-h group (p<0.001 for all).

No significant between-group difference was observed in the incidence of neutropenia, and none of the patients developed FN.

The study was limited by its open-label, single-centre design and its relatively small sample size, according to the investigators.