ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026
Real-world use of G-CSF primary prophylaxis in small cell lung cancer: secondary data analysis from the French national cohorts KBP-2020-CPHG and ESCAP-2020-CPHG.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSmall-cell lung cancer (SCLC) is an aggressive malignancy frequently associated with chemotherapy-induced febrile neutropenia (FN), particularly with etoposide-platinum-based regimens. G-CSF primary prophylaxis (PP) is recommended according to regimen-level FN risk and patient-related risk factors. This study was aimed at describing the real-world use of G-CSF primary prophylaxis in patients with SCLC in France and at exploring survival outcomes descriptively.
methodsThis analysis used data from the prospective French national KBP-ESCAP-2020 cohorts, including patients newly diagnosed in 2020 and treated in non-academic public hospitals. Eligibility for G-CSF primary prophylaxis was determined according to chemotherapy regimen-level FN risk and patient-related risk factors based on guideline recommendations.
resultsAmong 527 SCLC patients, 447 (84.8%) met the predefined eligibility criteria for G-CSF primary prophylaxis, of whom 285 (63.8%) received prophylaxis. G-CSF PP was more commonly administered to younger patients (mean age 66.4 vs. 69.4 years, p < 0.001) and those with a better PS (0-1 in 76.3% vs. 56.0%, p < 0.0001). In the sensitivity analysis, 439 patients remained eligible, of whom 281 (64.0%) received prophylaxis. Among patients eligible for G-CSF primary prophylaxis, median OS was 11.2 months [95% CI 10.2-12.0] with 3- and 6-month OS of 89.8% [86.4-93.4] and 75.4% [70.6-80.6] in the PP group, vs. 8.4 months [6.7-10.0], 72.8% [66.3-80.0], and 63.0% [55.9-70.9] in the non-PP group. PFS at 3 and 6 months was 86.7% [82.8-90.7] and 56.1% [50.7-62.2] vs. 70.4% [63.7-77.8] and 51.2% [44.1-59.5]. These estimates are descriptive, with baseline imbalances between groups and the associated survival curves cross at around 12 months.
conclusionsIn this large real-world French cohort, G-CSF primary prophylaxis was administered to approximately two-thirds of patients meeting the predefined eligibility criteria, suggesting incomplete implementation of guideline recommendations. This proportion remained essentially unchanged in the sensitivity analysis.
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