Do you consider TBO–filgrastim identical, in terms of response and tolerance, to filgrastim?

National Marrow Donor Program/Be The Match Donor Medical Services and the Medical Director at Health Services Research and the Senior Scientific Director at the Center for International Blood and Marrow Transplant Research in Milwaukee, Wisconsin and president of the American Society of Hematology

This month, Linda J. Burns, MD, answers a question about the similarities between TBO-filgrastim and filgrastim.

CLINICAL DILEMMA

Do you consider TBO–filgrastim identical, in terms of response and tolerance, to filgrastim? Is it correct to switch 300 µg filgrastim to 300 µg TBO–filgrastim?

EXPERTS MAKE THE CALL

Recent reviews have shown that filgrastim and TBO-filgrastim (a nonglycosylated recombinant methionyl human granulocyte colony-stimulating growth factor) are similarly effective in treating treatment-related febrile neutropenia, suggesting that it would be correct to switch 300 µg filgrastim to 300 µg TBO–filgrastim.

Dosing of filgrastim and TBO-filgrastim are the same, with similar responses and tolerance, as reported in a literature review of randomized clinical trials, meta-analyses, and systematic reviews for the use of hematopoietic colony-stimulating factors.1 In the review, filgrastim and TBO-filgrastim have demonstrated similar safety and efficacy in reducing the rate of first-cycle treatment-related neutropenia, with an adjusted difference of 1.7 percent (95% CI 3.8-7.1%) with no statistically significant difference between the two drugs.

In the setting of autologous hematopoietic cell transplantation, filgrastim and TBO-filgrastim have also demonstrated comparable safety and efficacy, with no statistically significant differences in mobilization and neutrophil engraftment.2


References

  1. Smith TJ, Bohlke K, Lyman GH, et al. Recommendations for the use of WBC growth factors: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol. 2015;33:3199-212.
  2. Elayan MM, Horowitz JG, Magraner JM, et al. Tbo-filgrastim versus filgrastim during mobilization and neutrophil engraftment for autologous stem cell transplantation. Biol Blood Marrow Transplant. 2015;21:1921-5.

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