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Survival Outcomes Associated With Short-Acting Versus Long-Acting G-CSF Use During First-Line Chemoimmunotherapy for
Yanjuan Xiong1,2,3,4,5,6, Wenjing Guo1,2,3,4,5,6, Chenxi Ma1,2,3,4,5,6
1Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
International Journal of Cancer
|July 16, 2026
Summary
Granulocyte colony-stimulating factor (G-CSF) prevents neutropenia in lung cancer patients on chemoimmunotherapy. Short-acting G-CSF improved survival outcomes compared to long-acting formulations.
Area of Science:
- Oncology
- Immunology
- Pharmacology
Background:
- Granulocyte colony-stimulating factor (G-CSF) is crucial for managing chemotherapy-induced neutropenia.
- G-CSF influences immune cells, potentially impacting immunotherapy efficacy.
- The differential effects of G-CSF formulations on advanced lung cancer survival are not well-understood.
Purpose of the Study:
- To investigate the impact of G-CSF and its formulations on survival in advanced lung cancer patients undergoing first-line chemoimmunotherapy.
- To compare the efficacy of short-acting recombinant human G-CSF (rhG-CSF) versus long-acting pegylated recombinant human G-CSF (PEG-rhG-CSF).
Main Methods:
- Retrospective study of 606 advanced primary lung cancer patients receiving first-line chemoimmunotherapy.
- Inverse probability of treatment weighting (IPTW) to balance patient groups.
- Kaplan-Meier and Cox models to analyze overall survival (OS) and progression-free survival (PFS).
Main Results:
- G-CSF support effectively mitigated the negative survival impact of neutropenia.
- No significant difference in PFS or OS between the G-CSF and no-G-CSF groups after IPTW.
- Patients receiving rhG-CSF showed significantly improved OS (42.6 vs. 28.2 months) and PFS (15.4 vs. 9.4 months) compared to PEG-rhG-CSF.
- rhG-CSF was an independent favorable prognostic factor for PFS and OS.
Conclusions:
- G-CSF effectively manages chemotherapy-induced neutropenia in advanced lung cancer patients on chemoimmunotherapy.
- Short-acting rhG-CSF demonstrated superior clinical outcomes compared to long-acting PEG-rhG-CSF.
- Prospective trials are needed to confirm these findings and guide clinical practice.
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