383P Survey for patterns of G-CSF use among cancer patients receiving chemotherapy in Asia

Abstract

Aim/Background: Several cancer trials and reviews have highlighted the higher incidence of hematologic toxicity in the Asian patients. The use of G-CSF for prophylactic and therapeutic purposes in managing febrile neutropenia varies widely in clinical practice.In the absence of any existing guidelines specific for Asian patients and attempting to estimate the treating oncologist's preferences and decision points in managing neutropenia with the use of G-CSF in their routine practice, we designed this survey. Methods: The survey was done with treating Oncologists across 10 Asian countries through click tools. For this submission related data, we had kept the survey open between 3rd to 18th August, 2015. This survey is ongoing till 15th of September. The final outputs would be descriptively analysed and applicable statistical tests would be performed. Results: Total effective responders are 54. In guiding practice, 51% follow NCCN, 22.4% follow ASCO. 66% of physicians think dose intensity of chemo is important for chemo-sensitive tumors patients' survival/efficacy regardless curative or palliative intent, the rests think it important for all of tumor types. During dose dense chemotherapy, majority (89%) prefer G-CSF usage to manage FN rather than hold or reduce chemotherapy dose. In patients with afebrile neutropenia, whatever tumor types, most of doctors would prefer keeping same dose of chemotherapy while using G-CSF for secondary prophylaxis. All physicians consider more than 1 factors to determine the need of primary prophylaxis for patients at risk of FN, and the below factors are most relevant: Aged > 65 (76%), poor performance status (72.2%), cytopenia due to bone marrow involvement (70.4%), active or increased risk of infections (55.6%), poor nutritional status (48.1%) et all. For filgrastim course treatment, majority (73.6%) would use ANC 1000-4999 cells/l as stopping criteria. Convenience and cost are two main factors for doctors to decide selecting Peg filgrastim over filgrastim. Conclusions: There is marked variability in practice patterns across Asia and an important unmet medical need to define prophylaxis and patient selection criteria in the Asian context is emerging. Full results will be presented at the meeting.