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Filgrastim (Neupogen and its biosimilars) is a daily injection that speeds the recovery of infection-fighting white cells after chemotherapy, lets doctors give chemotherapy on schedule and mobilises stem cells for transplant.
Filgrastim was approved by the FDA in February 1991 to reduce the incidence of infection from febrile neutropenia in non-myeloid malignancies receiving myelosuppressive chemotherapy, and later for AML induction, bone marrow transplantation, peripheral blood progenitor cell mobilisation, severe chronic neutropenia and acute radiation syndrome. It was the first Amgen blockbuster and the model for supportive-care biologics; the first US biosimilar of any kind was filgrastim-sndz (Zarxio, 2015), and the EU authorised the first filgrastim biosimilars in 2008. Guidelines recommend primary prophylaxis when the febrile neutropenia risk of a regimen exceeds about 20%. Bone pain is the main adverse effect; splenic rupture, acute respiratory distress syndrome and sickle cell crises are rare but serious. Pegfilgrastim gives a once-per-cycle alternative.
Backbone ribbon from PDB 1RHG. RCSB PDB 1RHG. The ribbon widens where the chain is folded into a regular pattern and narrows where it is a loose loop.
Recombinant methionyl human G-CSF that binds the G-CSF receptor on myeloid progenitors, driving neutrophil proliferation, differentiation and release from marrow.
1.Filgrastim (G-CSF) slips into a pocket on its target.
| Region | Year | Indication |
|---|---|---|
| US | 1991 | Reduction of febrile neutropenia in non-myeloid malignancies on myelosuppressive chemotherapy; later AML induction, transplantation, stem cell mobilisation, severe chronic neutropenia |
| US | 2015 | First US biosimilar (Zarxio, filgrastim-sndz); further biosimilars 2018 onwards |
| EU | 2008 | First biosimilar filgrastims (Tevagrastim, Ratiograstim, Biograstim); Zarzio 2009 |
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Query for this drug: (TITLE:"Filgrastim" OR ABSTRACT:"Filgrastim" OR TITLE:"G-CSF" OR ABSTRACT:"G-CSF" OR TITLE:"Neupogen" OR ABSTRACT:"Neupogen" OR TITLE:"Zarxio filgrastim-sndz" OR ABSTRACT:"Zarxio filgrastim-sndz" OR TITLE:"Nivestym filgrastim-aafi" OR ABSTRACT:"Nivestym filgrastim-aafi" OR TITLE:"Releuko filgrastim-ayow" OR ABSTRACT:"Releuko filgrastim-ayow") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Filgrastim (G-CSF), not a curated reading list.
Shares Teva Pharmaceuticals, Pegfilgrastim, Growth factors: G-CSF and febrile neutropenia prevention and the tag supportive.
Shares Rituximab, Rasburicase, and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Advanced B-Cell Leukemia or Lymphoma and the tag supportive.
Shares Amgen and the tag supportive.
Shares Amgen and the tag supportive.
Shares Growth factors: G-CSF and febrile neutropenia prevention and the tag supportive.
Shares Amgen and the tag supportive.
Shares Phase 2 Trial of Prophylactic Rituximab Therapy for Prevention of CGVHD and the tag supportive.
Shares Teva Pharmaceuticals and the tag supportive.