Future strategy for cancer treatment using recombinant human granulocyte colony stimulating factor

Recombinant human granulocyte colony stimulating factor (rHuG-CSF) has an accepted use in reducing the severe neutropenia and associated complications in patients who undergo chemotherapy or bone marrow transplantation (BMT). It is valuable in mobilising peripheral blood progenitor cells (PBPCs) for stem cell rescue after myeloablative chemotherapy as an alternative to BMT. rHuG-CSF also allows chemotherapy dose/schedule optimisation and intensification, although a clear survival advantage has yet to be demonstrated. Recommendations for the focus and methodology of future studies with rHuG-CSF have been made, incorporating the endpoints of survival, quality of life and cost/benefit. Future studies need to address the questions of optimal dosing level and duration, cytokine combinations, the factors influencing patient survival, and the most cost-effective use of therapy. rHuG-CSF has potential for extended use in cancer therapy and in a variety of non-malignant indications.