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filgrastim (Grastofil)

✓ Approved

Apobiologix · CSF3R · 重组蛋白

什么是 filgrastim？

filgrastim 是一种重组蛋白，由Apobiologix研发。该药已获批，用于治疗相关适应症，给药途径：Injectable (Others)、Subcutaneous Injection。

药物档案

商品名Grastofil
公司Apobiologix
药物类别重组蛋白
分子靶点CSF3R
给药途径Injectable (Others), Subcutaneous Injection
状态Approved
来源： ClinicalTrials.gov, Apobiologix

作用机制

分子靶点

filgrastim 作用于 1 个分子靶点：

CSF3Rcolony stimulating factor 3 receptor (CD114, GCSFR)
需要更深入的分析？Noah AI 可解释复杂机制并与同类药物比较。

治疗适应症

filgrastim 针对 3 个适应症，涉及 2 个治疗领域。

治疗领域疾病/病症分期
Blood and lymphatic system disordersNeutropenia✓ Approved
Surgical and medical proceduresHaematopoietic stem cell mobilisation✓ Approved
Blood and lymphatic system disordersBone marrow disorder✓ Approved

相关研究文献

PubMedClinical kidney journal2026-09-08

Crescentic transformation induced by granulocyte-colony stimulating factor administration-a case report and review of the literature.

Seshadri Hariharan H, Falahat Yassmin Y, Abdelrahim Waseem W, Geng Yimin Y et al.

The use of recombinant human granulocyte-colony stimulating factor (G-CSF) is an uncommon aetiology for acute kidney injury in cancer patients. Several patterns of renal injury due to G-CSF have been discussed in the literature. Here, we present a case of a 48-year-old man with monoclonal gammopathy of renal significance who received filgrastim for planned autologous stem cell transplantation and developed acute kidney injury presenting as crescentic glomerulonephritis. The patient was treated with steroids, plasmapheresis, and cyclophosphamide. He attained complete recovery and proceeded with stem cell transplantation. We conducted an extensive review of the literature on the subject, which revealed that 10 of the 18 biopsy-proven cases of G-CSF-induced renal injury presented as crescentic glomerulonephritis. When G-CSF is administered to patients with an underlying renal pathology (usually autoimmune or monoclonal in aetiology), the migration and degranulation of activated neutrophils in the glomerular microenvironment in large numbers results in glomerular basement membrane rupture and crescent formation. Timely renal biopsy and aggressive initiation of treatment aid in attaining renal recovery and a favourable prognosis in cancer patients.

PMID 42708005
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PubMedRecenti progressi in medicina2026-09-03

[Efficacy and safety of sacituzumab govitecan in patients with metastatic HR+/HER2- pleomorphic lobular breast cancer complicated by renal impairment.]

Martinelli Claudia C

The case concerns a 68-year-old female patient with metastatic HR-positive/HER2-negative pleomorphic lobular breast carcinoma and severe chronic renal impairment since diagnosis, previously treated with multiple lines of therapy. At diagnosis in September 2021, the disease was already metastatic, with bone, nodal, and pleural involvement. The patient received endocrine therapy with CDK4/6 inhibitors, chemotherapy, and targeted agents, with subsequent multiorgan progression. The clinical course was further complicated by persistent severe renal impairment requiring urinary diversion procedures prior to sacituzumab govitecan initiation. In November 2025, the patient experienced multiorgan progression and clinical deterioration (ECOG PS 2), including ascites, peripheral edema, dyspnea, and anorexia. Following multidisciplinary evaluation, sacituzumab govitecan was initiated in December 2025 at full dose (10 mg/kg), with primary prophylaxis using filgrastim. During the first cycle, worsening renal function and grade 2 toxicity occurred, leading to omission of day 8 administration. Treatment was subsequently resumed at a reduced dose (7.5 mg/kg), achieving good tolerability, stabilization of renal function, and clinical benefit. At reassessment in March 2026, a partial response was documented. The patient is currently continuing treatment with overall good tolerability. This case highlights the feasibility of a personalized approach with sacituzumab govitecan in frail patients with severe renal impairment and lobular breast cancer, populations underrepresented in clinical trials.

PMID 42684174
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PubMedJCO global oncology2026-08-20

Clinical Implications and Prevalence of Duffy-Null Associated Neutrophil Count in Patients With Breast Cancer of Middle Eastern Ethnicity.

Prem Sudha Shruti S, Abdelfattah Nabil M NM, Yetisyigit Tarkan T, Najeebi Taif T et al.

Duffy-null associated neutrophil count (DANC), formerly known as benign ethnic neutropenia, is seen in people of African and Middle Eastern descent and does not represent a true neutropenic state. Individuals with DANC can be identified by the Duffy-null phenotype on red cells. There is evidence that cancer patients with DANC are not at an increased risk of infection with chemotherapy. The aims of this study were to assess the prevalence of DANC among patients with breast cancer of Middle Eastern ethnicity and to study treatment delays, infectious complications, and survival in these patients. We retrospectively reviewed 493 patients with breast cancer treated in a referral oncology center in Bahrain. Patients with neutropenia or leukopenia at presentation with Duffy-null phenotype and no identifiable secondary causes of neutropenia were presumed to have DANC. Clinical details studied included treatment delays, filgrastim responsiveness, and episodes of febrile neutropenia. A contemporaneous group of patients with breast cancer without DANC were used for comparison. Seventy-two patients (14.6%) had a presumed diagnosis of DANC, and the median neutrophil count at presentation was 1.2 × 103/µL (range, 0.4-2.1 × 103/µL). Treatment delays and discontinuations were significantly more common in patients with DANC (P < .001) and were not decreased by prophylactic filgrastim use. Patients with DANC were uniformly filgrastim responsive, and only one patient had neutropenic fever. There was no effect of treatment delay or DANC on OS or PFS. DANC is prevalent among patients with breast cancer in Bahrain, and Duffy phenotyping on red cells can be a surrogate marker for diagnosis. Treatment delays because of the apparent neutropenia are common in DANC; however, febrile neutropenia is uncommon. This study is of particular relevance in populations with a high prevalence of DANC.

PMID 42623593
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PubMedCureus2026-08-20

Cryptococcal Meningitis Revealing Late-Onset Combined Immunodeficiency After Two Decades of Recurrent Infections: A Case Report.

Martínez Evangelista Valeria J VJ, Munoz Plascencia Sandra S, Cárdenas-Favela Juan C JC, Correa Serrano Carlos A CA

Adult-onset inborn errors of immunity pose a significant diagnostic challenge because of their non-specific clinical presentation and frequent delay in diagnosis. We report a case of a 53-year-old woman with a nearly two-decade history of recurrent infections whose clinical course culminated in cryptococcal meningitis, prompting a comprehensive immunologic evaluation. Following the systematic exclusion of secondary causes of immunodeficiency, immunologic testing revealed hypogammaglobulinemia and profound CD4+ T-cell lymphopenia (188 cells/µL), consistent with combined humoral and cellular immune dysfunction and supporting classification within the late-onset combined immunodeficiency (LOCID) phenotype. Following appropriate antifungal therapy, subsequent immunoglobulin replacement therapy and filgrastim were associated with sustained clinical improvement. This case highlights that cryptococcal meningitis in HIV-negative patients should prompt a systematic evaluation for an underlying primary immunodeficiency and underscores the importance of recognizing the LOCID phenotype as an uncommon but potentially treatable cause of opportunistic infections in adults.

PMID 42621176
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PubMedHematology, transfusion and cell therapy2026-07-31

Improving engraftment in autologous hematopoietic stem cell transplantation: comparing pegfilgrastim with filgrastim in an outpatient setting.

Gutierrez-Aguirre Cesar Homero CH, la Garza-Salazar Fernando De F, Gómez-Almaguer David D, Jaime-Pérez José Carlos JC et al.

Febrile neutropenia, a frequent complication in patients undergoing autologous stem cell transplantation, increases morbidity and hospitalization costs. The aim of this study was to compare the efficacy of two formulations of pegylated filgrastim with filgrastim in patients who received autologous stem cell transplantation as outpatients for lymphoma or myeloma. Thirty patients were randomized to receive a single 6 mg dose of either reference or biosimilar pegfilgrastim on Day +1. A retrospective Control Group of fifty-three patients who received filgrastim was included. The median times to neutrophil engraftment were 10, 9 and 11 days for the innovator pegfilgrastim, biosimilar pegfilgrastim (p-value = 0.14), and filgrastim (p-value = 0.0001), respectively. The median times to platelet engraftment were 10 days for both of the pegfilgrastim groups and 12 days for the filgrastim group (p-value = 0.0001). Febrile neutropenia incidence was lower in the pegfilgrastim group (6.7%) than in the filgrastim group (24.5%; p-value = 0.04). Cost analysis showed higher costs for the innovator pegfilgrastim, with filgrastim having the lowest cost of the three formulations. The innovator and the biosimilar pegfilgrastim demonstrated similar efficacy in engraftment speed and febrile neutropenia incidence. Pegfilgrastim was associated with faster engraftment, a lower incidence of platelet transfusion, and a lower incidence of febrile neutropenia.

PMID 42531780
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PubMedImmunotherapy advances2026-07-25

Growth factor supportive care for chemotherapy-induced neutropenia suppresses antitumour immunity in checkpoint blockade-responsive pancreatic cancer.

Parent Brendan D BD, Kelly Anthony E AE, Hoffman Megan T MT, Dougan Michael M et al.

Growth factors, including granulocyte colony-stimulating factor (G-CSF; pegfilgrastim, filgrastim), are used for prophylaxis or treatment of chemotherapy-induced neutropenia, yet their effects on antitumour immunity remain incompletely understood. We previously found that serum from patients with pancreatic ductal adenocarcinoma (PDAC) treated with multiagent chemotherapy plus G-CSF drove differentiation of T cell-suppressive monocytes in vitro, suggesting that supportive care interventions may shape immune responses in this disease. We evaluated the immunologic and therapeutic impact of G-CSF in two murine PDAC models that differ in their baseline frequencies of infiltrating T cells and in their responsiveness to checkpoint blockade immunotherapy. In poorly immunogenic, T-cell-low tumours, use of G-CSF did not affect tumour growth or response to chemo- or immunotherapy, although neutrophil recovery was improved in mice receiving FOLFIRINOX and G-CSF compared to chemotherapy alone. In immunogenic tumours with a robust endogenous T-cell response, combination anti-PD1 and anti-CTLA-4 therapy resulted in durable tumour clearance. Combination with G-CSF diminished the effectiveness of checkpoint blockade and resulted in significantly fewer cured mice. G-CSF, commonly used for supportive care with FOLFIRINOX and other chemotherapy regimens, induces systemic immune suppression that can reduce the efficacy of T-cell-targeting immunotherapies.

PMID 42500327
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