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Pegfilgrastim (Neulasta) is a long-acting form of the growth factor G-CSF, given once per chemotherapy cycle to speed white cell recovery and prevent febrile neutropenia; one dose replaces about eleven daily filgrastim injections. Biosimilars have been sold since 2018 and the Onpro on-body injector delivers it automatically the day after chemotherapy; bone pain is the main side effect.
Pegfilgrastim was approved by the FDA in January 2002 to decrease the incidence of infection manifested by febrile neutropenia in non-myeloid malignancies receiving myelosuppressive chemotherapy, on randomised trials showing a single 6 mg dose per cycle equivalent to about 11 daily filgrastim injections; the EU authorised Neulasta in August 2002 and an acute radiation syndrome indication was added in the US in 2015. It became one of the highest-selling cancer drugs before biosimilars arrived (Fulphila and Udenyca in 2018, Ziextenzo, Nyvepria, Fylnetra, Stimufend and others since), and the Onpro on-body injector avoids a next-day clinic visit. It is not indicated for stem cell mobilisation. Bone pain is the main adverse effect; splenic rupture, capillary leak, aortitis and glomerulonephritis are rare.
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.
The 20 kDa PEG chain is not shown.
Filgrastim with a 20 kDa polyethylene glycol chain that abolishes renal clearance so that elimination depends on neutrophil-mediated uptake; levels fall as neutrophils recover, giving self-regulating once-per-cycle dosing.
1.Pegfilgrastim slips into a pocket on its target.
Compare all products across the US, EU, UK, Japan, China and Australia →
| Region | Year | Indication |
|---|---|---|
| US | 2002 | Decrease in febrile neutropenia in non-myeloid malignancies on myelosuppressive chemotherapy (acute radiation syndrome added 2015) |
| US | 2018 | First biosimilars (Fulphila, Udenyca); further biosimilars 2019 onwards |
| EU | 2002 | Reduction in duration of neutropenia and febrile neutropenia after cytotoxic chemotherapy (Neulasta); biosimilars from 2018 |
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Query for this drug: (TITLE:"Pegfilgrastim" OR ABSTRACT:"Pegfilgrastim" OR TITLE:"Neulasta" OR ABSTRACT:"Neulasta" OR TITLE:"Fulphila pegfilgrastim-jmdb" OR ABSTRACT:"Fulphila pegfilgrastim-jmdb" OR TITLE:"Udenyca pegfilgrastim-cbqv" OR ABSTRACT:"Udenyca pegfilgrastim-cbqv" OR TITLE:"Ziextenzo pegfilgrastim-bmez" OR ABSTRACT:"Ziextenzo pegfilgrastim-bmez" OR TITLE:"Nyvepria pegfilgrastim-apgf" OR ABSTRACT:"Nyvepria pegfilgrastim-apgf") 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 Pegfilgrastim, not a curated reading list.
Shares ACCELERATE: Doxorubicin and Cyclophosphamide Followed by Paclitaxel With Pegfilgrastim and Darbepoetin Alfa Support for the Treatment of Women With Breast Cancer, Docetaxel and Cisplatin With or Without Dimesna in Treating Patients With Stage IIIB or Stage IV Non-Small Cell Lung Cancer, Amgen and the tag supportive.
Shares Prevention of Anthracycline-Induced Cardiac Dysfunction With Dexrazoxane in Patients With Diffuse Large-B Cell Lymphoma and the tag supportive.
Shares Filgrastim (G-CSF) 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 Prevention of Anthracycline-Induced Cardiac Dysfunction With Dexrazoxane in Patients With Diffuse Large-B Cell Lymphoma and the tag supportive.
Shares Lipegfilgrastim, XM22-03, Efficacy and safety of lipegfilgrastim versus pegfilgrastim in breast cancer patients receiving doxorubicin and docetaxel (XM22-03), Filgrastim (G-CSF).