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Assessing Utilization Trends of Granulocyte Colony-Stimulating Factors (G-CSF) in an Outpatient Cancer Setting
Friday April 25, 2025 11:40am - 11:55am EDT
Olympia 2
Title: Assessing Utilization Trends of Granulocyte Colony-Stimulating Factors (G-CSF) in an Outpatient Cancer Setting   
Authors: Shayan Tavassoli, Alexia Greene, Thomas Morris 
Background: This study aims to identify gaps between current utilization and guideline recommendations by evaluating usage trends of granulocyte colony-stimulating factors at FirstHealth Outpatient Cancer Center. Previous literature showed that granulocyte colony-stimulating factors have shown both overuse and underuse when comparing to guideline recommendations.  
Methods: A retrospective observational study was conducted to evaluate the use of granulocyte colony-stimulating factors in cancer patients at FirstHealth Outpatient Cancer Center between March 1, 2022, and March 30, 2024. The study included patients with active diagnoses of breast, lung, pancreatic, or colorectal cancer who received a dose of granulocyte colony-stimulating factors. Exclusion criteria applied to patients receiving secondary prophylaxis for febrile neutropenia, weekly chemotherapy cycles, investigational agents, or those who underwent bone marrow or hematopoietic transplants within 30 days of chemotherapy. Patient characteristics included age, gender, cancer type, chemotherapy regimen, absolute neutrophil count, creatinine clearance, bilirubin levels, and provider documentation related to granulocyte colony-stimulating factors use. Patients were classified into three risk groups—high, intermediate, and low—based on the risk of febrile neutropenia according to NCCN guidelines. The primary outcome looked to find the percentage of patients who received at least one dose of granulocyte colony-stimulating factors for primary prophylaxis of febrile neutropenia during their chemotherapy regimen for the treatment of either lung, pancreatic, breast, or colorectal cancer. The secondary outcome looked to evaluate the characteristic differences between patients who received granulocyte colony-stimulating factors and those who did not during the study period. All patient data has been stored in a password-protected file with access restricted to investigators, ensuring confidentiality and data security throughout the study. 
Results: During the study’s timeframe, 4% (214/4931) patients with either lung, pancreatic, colorectal, or breast cancer received granulocyte colony-stimulating factors. Individual baseline characteristics were evaluated in total for 50 patients who received granulocyte colony-stimulating factors and 44 patients who did not receive granulocyte colony-stimulating factors. In the treatment group, 28% (14/50) vs. 6.8% (3/44) patients would be categorized as intermediate risk factor for febrile neutropenia based on guideline recommendations, and 86% (12/14) in treatment group vs. 100% (3/3) in control group of patients with intermediate risk chemotherapy regimen had risk factors to consider adding granulocyte colony-stimulating factors.
Conclusions: Overall, granulocyte colony-stimulating factor usage aligned closely with NCCN guideline recommendations in this study. Intermediate risk groups require consideration from providers when deciding if granulocyte colony-stimulating factors are necessary based on patient characteristics. Limited sample size may require further research to determine significant gaps of granulocyte colony-stimulating factors in comparison to guideline recommendations. 
Moderators
SC

Schylar Cheyenne Hathaway

Clinical Pharmacist
Special interest include Ambulatory Care and Women's Health.
Presenters
avatar for Shayan Tavassoli

Shayan Tavassoli

PGY1 Pharmacy Resident, FirstHealth Moore Regional Hospital
Shayan Tavassoli, PharmD who is a PGY1 pharmacy resident at FirstHealth Moore Regional Hospital in Pinehurst, NC. Shayan's interests include oncology, infectious disease, and emergency medicine. 
Evaluators
avatar for Lacey Ioppolo

Lacey Ioppolo

PGY-1 RPD and Clinical Pharmacy Manager, Memorial Health University Medical Center
Lacey Ioppolo PharmD, BCCCP, is a Clinical Pharmacy Manager and PGY-1 Pharmacy Residency Program Director at Memorial Health University Medical Center in Savannah, GA. She obtained her Doctor of Pharmacy from The University of Florida in 2018 and completed her PGY-1 Pharmacy Residency... Read More →
Friday April 25, 2025 11:40am - 11:55am EDT
Olympia 2
  Oncology (ONC), FirstHealth Moore Regional Hospital
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