Subsequent clinical trials and meta-analyses established that primary prophylaxis with filgrastim (beginning in the first cycle of chemotherapy) reduced the incidence of FN, FN-related
hospitalizations, intravenous anti-infective use, infection-related mortality, and the need for chemotherapy dose modification, compared with placebo or no treatment, in many tumor types. Pegfilgrastim, formed by the addition of a polyethylene glycol molecule to filgrastim, has comparable efficacy to filgrastim when administered only once per chemotherapy cycle. High-level evidence indicates that both filgrastim and pegfilgrastim improve the likelihood of completing dose-dense and dose-intense chemotherapy. The most recent guidelines from three international cancer organizations, the European Organization for Research and Treatment of Cancer, the American selleck chemical Society of Clinical Oncology, and the US National FDA-approved Drug Library Comprehensive Cancer Network, are in agreement that
filgrastim or pegfilgrastim should be given prophylactically when the risk of FN with a chemotherapy regimen is >= 20%, or when the risk is 10-20% and the patient has other risk factors for FN. The development of filgrastim and pegfilgrastim has revolutionized oncology practice. Prophylactic use of these agents has enabled development of more aggressive chemotherapy regimens, including dose-dense chemotherapy, and treatment of a broader range of patients.”
“Purpose: To investigate in vitro the factors affecting microdialysis probe delivery and recovery of puerarin.
Methods: The recovery and delivery of puerarin were tested for extraction efficiency
Selleck Dorsomorphin and retro-dialysis methods. Factors such as drug concentration, stirring speed, additives and length of membrane were studied to determine differences between recovery and delivery.
Results: It was observed that the delivery of the targeting analyte was different from its recovery. Both delivery and recovery of puerarin were independent of the concentration of the drug. Probe delivery increased from 62.18 to 67.98 % (p < 0.01), recovery from 59.19 to 78.44 % (p < 0.01), as stirring speed was increased from 0 to 800 rpm. The difference between them directly correlated with stirring speed in the range 2.99 to 10.46 %. Besides additives, length of membrane also had a strong influence on delivery and recovery. Probe delivery in saline containing 10 % each of ethanol and propylene glycol declined from 62.18 to 42.12 % (p < 0.01), while recovery increased slightly but insignificantly (p < 0.01). Both delivery and recovery declined when the length of membrane was reduced.
Conclusion: The in vitro experiments indicate that it would be incorrect to equate delivery with recovery of puerarin in in vivo microdialysis experiments.