ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2017
Use of prophylactic growth factors and antimicrobials in elderly patients with cancer: a review of the Medicare database.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- How Can Oncology Nurses and Advanced Practice Providers Reduce the Burden of Chemotherapy-Induced Febrile Neutropenia in the US?Journal of the advanced practitioner in oncology · 2024Review
- Comparative effectiveness of pegfilgrastim biosimilars vs originator for prevention of febrile neutropenia: A retrospective cohort study.Journal of managed care & specialty pharmacy · 2023Article
- A prospective study to evaluate febrile neutropenia incidence in patients receiving pegfilgrastim on-body injector vs other choices.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Observational
- Patterns of primary prophylactic granulocyte colony-stimulating factor use in older Medicare patients with cancer receiving myelosuppressive chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Trends in Use of Granulocyte Colony-Stimulating Factor Following Introduction of Biosimilars Among Adults With Cancer and Commercial or Medicare Insurance From 2014 to 2019.JAMA network open · 2021Article
- Patterns of granulocyte colony-stimulating factor prophylaxis in patients with cancer receiving myelosuppressive chemotherapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Article
- A Survey of Oncologists' Perceptions and Opinions Regarding the Use of Granulocyte Colony-Stimulating Factors.Journal of cancer education : the official journal of the American Association for Cancer Education · 2020Article
- Pegfilgrastim in primary prophylaxis of febrile neutropenia in elderly patients with hematological malignancies-bendamustine and G-CSF support.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGrowth factors and antimicrobials can reduce complications of chemotherapy-induced myelosuppression. Their prophylactic use in elderly patients is important given the associated comorbidity in this age group. There is a developing trend by payers to include supportive care agents in chemotherapy care bundles, which could affect clinical practice. We examined whether the febrile neutropenia (FN) risk categories can be used to describe utilization in the Centers for Medicare & Medicaid fee-for-service system in older adults.
methodsWe conducted a retrospective cohort study using the Medicare 20% sample data to describe growth factor and antimicrobial use patterns in patients receiving chemotherapy for breast cancer, lung cancer, and non-Hodgkin lymphoma (NHL).
resultsThe highest percentage of patients receiving granulocyte colony-stimulating factor (GCSF) within the first 5 days of a chemotherapy cycle were on high-FN-risk regimens, particularly for cycle 1 (73.7%, breast cancer; 61.5%, NHL) and cycle 2 (75.9%, breast cancer; 77.5%, NHL). Chemotherapy regimens for lung cancer are less myelotoxic, and growth factor use was more likely with latter cycles. Antibiotic use was lower at 15% within a cycle and appeared to be in response to complications.
conclusionPractitioners use GCSF and antibiotics for elderly patients treated with potentially toxic chemotherapy, while comorbidity burden plays a role for patients treated with less myelotoxic regimens. The complexity of these choices in clinical practice should be considered in the proposed reimbursement changes being piloted by Medicare and private insurance companies seeking treatment cost reductions, as altered use could affect safety and efficacy.
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