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EFLAPEGRASTIM-XNST INJ,SOLN

Clinical Criteria Summary

Indications & Target Population

  • Decrease the incidence of infection (febrile neutropenia) in patients with non-myeloid malignancies receiving myelosuppressive cancer drugs.
  • Not for mobilization for peripheral progenitor cells for stem cell transplantation.
  • Clinical trial data supports use in early-stage breast cancer receiving adjuvant chemotherapy (docetaxel and cyclophosphamide).

Contraindications

  • Serious allergic reaction to human G-CSF.

Warnings & Precautions

  • Splenic rupture
  • ARDS
  • Serious allergic reactions
  • Sickle Cell crisis
  • Glomerulonephritis
  • Leukocytosis
  • Thrombocytopenia
  • Capillary leak syndrome
  • Stimulation of tumor growth
  • MDS/AML in breast and lung cancer patients

Dosing & Administration

  • 13.2 ng/0.6mL pre-filled syringe for subcutaneous injection once each chemotherapy cycle.

Safety Profile

  • Adverse reactions ≥20%: fatigue, nausea, diarrhea, bone pain, headache, pyrexia, anemia, rash, myalgia, arthralgia, back pain.
  • Safety during clinical trials was comparable to pegfilgrastim despite a lower G-CSF dose.

Formulary & Place in Therapy Considerations

  • No clear place in therapy for eflapegrastim instead of pegfilgrastim.
  • Application withdrawn in 2019 due to manufacturing issues.

Source Documents