Real-world use of G-CSF in patients with breast cancer during first wave of COVID-19 in Germany

Objective The first wave of the Covid-19 pandemic hit Germany early 2020 (Jan–Jun). Expert associations updated recommendations regarding primary prophylaxis (PP) for oncologic patients with intermediate risk for febrile neutropenia (FN). This work examines therapy protocols and the use of G-CSF for patients with breast cancer before, during and after the first wave.

Material & Methods Data was collected and analyzed as part of the healthcare research project ‘LiveTicker’ using SPSS for statistical analyses. Data on 3132 breast cancer patients was provided by 76 office-based oncologists between Jul-2019 & Dec-2020

Results 19% of patients received PP with G-CSF during treatment. Majority of these patients were aged 41–60 (62%) and in average ~10 older than the non-PP group. 198 different protocols were reported: Most frequent were EC (38%) and pertuzumab+trastuzumab (10%) for regimes with and without PP, respectively. EC-based therapies decreased Jan-Jun 2020, especially for patients aged 41 – 55. A total of 2598 G-CSF prescriptions were reported (Pegfilgrastim: 78%, Lipegfilgrastim: 11%, Filgrastim:11%). EC protocols were not often chosen for patients > 65 yrs (~11%) and most planned with PP were dose dense (90%). Supportive G-CSF was not documented for 17% of dose dense and 85% for dose normal EC therapies.

Summary Our real-world evidence depicts a decrease of intensive protocols but no significant change in protocols or G-CSF use in intermediate FN risk settings due to Covid-19 pandemic. Data suggests that in some real-world settings high-risk FN cases might lack PP, additional evidence is required to evaluate these cases.

Publication History

Article published online:
21 June 2022