Our aim was to compare the efficacy and safety of two recently developed biosimilars of pegfilgrastim, a pegylated form of the recombinant human granulocyte-colony stimulating factor (G-CSF) analog filgrastim with those of the reference pegfilgrastim. We retrospectively analyzed data from patients diagnosed with diffuse large B-cell lymphoma (DLBCL) who were treated with first-line R-CHOP chemotherapy and received pegylated G-CSF for primary prophylaxis. The following pegylated G-CSFs were analyzed in this study: reference pegfilgrastim (Neulasta® ) and two of its biosimilars (tripegfilgrastim; Dulastin® and pegteograstim; Neulapeg® ). In total, 296 patients were enrolled. The number of patients with at least one episode of neutropenia during R-CHOP chemotherapy was the lowest in the reference cohort (pegfilgrastim: 127 of 193 patients, 65.8%; tripegfilgrastim: 64 of 69 patients, 92.8%; pegteograstim: 28 of 34 patients, 82.4%, P < .001). The number of patients with at least one episode of febrile neutropenia was also lowest in the reference cohort (pegfilgrastim: 67 of 193 patients, 34.7%; tripegfilgrastim: 38 of 69 patients, 55.1%; pegteograstim: 16 of 34 patients, 47.1%, P = .009). There were no differences in the duration of neutropenia and febrile neutropenia or treatment outcomes (rate of complete response or relapse and survival). There were no reports of grade 3 or higher adverse events requiring discontinuation of prophylactic pegylated G-CSF in any group. The safety of the pegfilgrastim biosimilars for prophylactic purposes was comparable to that of the reference pegfilgrastim; however, in terms of their efficacy, the incidence of neutropenia and febrile neutropenia tended to be higher than that when using pegfilgrastim. The clinical relevance of these results in the biosimilar cohorts should be explored.

译文

:我们的目的是比较两种新近开发的pegfilgrastim生物仿制药的功效和安全性,pegfilgrastim是一种聚乙二醇化形式的重组人粒细胞集落刺激因子(G-CSF)类似物非格司亭的聚乙二醇化形式,与参考pegfilgrastim的仿制药相似。我们回顾性分析了诊断为弥散性大B细胞淋巴瘤(DLBCL)的患者的数据,这些患者接受了一线R-CHOP化疗并接受了聚乙二醇化G-CSF的一级预防。在本研究中分析了以下聚乙二醇化的G-CSF:参比非格司亭(Neulasta®)及其两种生物仿制药(tripegfilgrastim;Dulastin®和pegteograstim;Neulapeg®)。总共招募了296名患者。在参考队列中,R-CHOP化疗期间发生至少1次中性粒细胞减少症的患者人数最低(pegfilgrastim:193名患者中的127名,占65.8%; tripegfilgrastim:69名患者中的64名,占92.8%; pegteograstim:34名患者中的28名,82.4%,P <.001)。在参考队列中,至少发生一次发热性中性粒细胞减少症的患者人数也最低(pegfilgrastim:193例患者中的67例,占34.7%; tripegfilgrastim:69例患者中的38例,占55.1%; pegteograstim:34例患者中的16例,占47.1%, P = .009)。中性粒细胞减少和发热性中性粒细胞减少的持续时间或治疗结果(完全缓解率或复发率和生存率)没有差异。在任何组中均没有3级或更高级别不良事件需要预防性聚乙二醇化G-CSF停药的报道。 pegfilgrastim生物仿制药在预防方面的安全性与参考pegfilgrastim相似。然而,就其功效而言,中性粒细胞减少和发热性中性粒细胞减少的发生率往往比使用培非非司亭时高。这些结果在生物仿制药研究中的临床意义应予以探讨。

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