Pattern of granulocyte colony stimulating growth factors (G-CSGF) usage in patients treated with sacituzumab govitecan: A real world multicenter study using the TriNetX database.
Year: 2025
Type: conference-abstract
Abstract: e13145 Background: Sacituzumab Govitecan (SG) a Trop2-targeted antibody-drug conjugate (ADC) was reported to cause neutropenia among 63% patients in clinical trials [Bardia, NEJM 2021]. G-CSFs are often used to manage chemotherapy-induced neutropenia. However, data on the pattern of G-CSF use among patients receiving SG in real-world settings remain limited. This study aims to evaluate the utilization patterns of G-CSFs in patients treated with Sacituzumab Govitecan and analyze their demographic and clinical characteristics that put them at greater risk for neutropenia using using the TriNetX database. Methods: We conducted a retrospective study using the TriNetX database. SG and G-CSF (filgrastim or PEG filgrastim) were identified using RxNorm coding (2360231, 68442, 338036) and neutropenia was identified using ICD-10-CM code. We limited neutropenia or G-CSF usage events to occur within 21 days of SG. We compared cohort SG with neutropenia to SG without neutropenia using TrinetX built-in feature (outcome comparison) for demographic, comorbidities and laboratory parameters. We analyzed the incidence of G-CSF usage in the two cohorts. Results: We analyzed 117 million+ de-identified patients, of which 2317 patients received SG. 28% (639/2317) of the SG recipient had neutropenia (SGN+ cohort), while 72% (N = 1678) did not have neutropenia (SGN- cohort) within 21 days of SG. When the two cohorts were compared, factors associated with neutropenia were Obesity (32% v/s 21%, p < 0.0001), Diabetes Mellitus (25% v/s 18%, p 0.0002), Hypertension (56% v/s 42%, p < 0.0001), Ischemic heart disease (20% v/s 15%, p 0.0034), Cerebrovascular accident (12% v/s 9%, p 0.0203), Chronic kidney disease (17% v/s 12%, p 0.0038). The pattern of use of G-CSF usage differed among the two groups. Among SGN+ cohort, 61% (390/639), received C-GSF, while among SGN- cohort, it was 37% (621/1678). Results in this study are based of TriNetX data available as of 1/28/2025. Conclusions: Our study reveals a lower real-world incidence of neutropenia (28%) among Sacituzumab Govitecan recipients compared to clinical trial reports (63%), suggesting potential differences in patient characteristics or treatment practices. Despite this, most patients who developed neutropenia (61%) required G-CSF support, indicating a significant clinical burden. However, the limited prophylactic use of G-CSF (37%) highlights the need for further research to optimize preventive strategies and mitigate neutropenia-related complications in real-world settings.
Source: Journal of Clinical Oncology
Institutions: MacNeal Hospital, Loyola Medicine, Anne Arundel Medical Center, SUNY Upstate Medical University, Beaumont Health, Beaumont Hospital, Royal Oak, Texas Tech University Health Sciences Center, Karachi Medical and Dental College, Thomas Jefferson University, University of Vermont Medical Center, George Washington University Hospital
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410804597