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Background Chemotherapy-induced neutropenia is commonly encountered in clinical practice. The management of neutropenia has been evolving from short-acting granulocyte colony-stimulating factors (G-CSFs) to long-acting G-CSFs. However, an evaluation of the safety and effectiveness of long-acting G-CSFs in clinical practice is still lacking. Methods This multicenter, non-interventional study was aimed at exploring the safety and effectiveness of mecapegfilgrastim in different cancer patients in China. All patients provided written informed consent prior to the study and were treated according to routine clinical practice. Different prophylactic strategies (primary or secondary prophylaxis) were also compared. Results This study included 638 patients from May 2019 to November 2020. More than half of the participants were breast cancer patients. The mean age of all the patients was 56 years. White blood cell increase (6.2%) was the most frequently reported adverse event (AE) possibly related to the study drug. No unexpected AEs were reported. Grade ≥3 neutropenia in chemotherapy treatment cycle 1 was reported in 36 (5.6%) patients. Incidence of grade ≥3 neutropenia in cycle 1 in the primary and secondary prophylaxis subgroups were of 4.3% and 9.2%, respectively. A decreasing trend of severe neutropenia incidence was observed from cycle 1 to cycle 4. Conclusions Mecapegfilgrastim was generally well tolerated, and no unexpected AEs were observed in this study. Primary administration of mecapegfilgrastim led to a lower incidence of neutropenia than did secondary administration. Continuous administration of mecapegfilgrastim could keep the incidence of neutropenia to a relatively low level.

Education is a fundamental right for every child. Many international institutions, such as UNESCO, UNICEF and World Bank, suggest the adoption of inclusive education, which guarantees equal opportunities of for all the children, especially for those who have special educational needs (SEN). Children with pediatric cancer are considered as the ones having SEN, because the long-term treatment caused educational delay and absence from school. This essay shall: (1) describe current background context and rationale regarding the reliability of this curriculum design in Children’s Hospital of Chongqing Medical University; (2) explain the implementation and curriculum plan based on Sect. 2.1; and (3) analyze the evaluation and potential problems of this curriculum.

Background: Neutropenia is a frequently reported adverse event in patients with hematologic malignancies. Prophylactic administration of long-acting granulocyte colony stimulating factor(G-CSF) had been widely applied in different solid tumors. However, the effect of long-acting G-CSF in patients with hematologic malignancies was not well studied. Methods: A multi-center, non-interventional study was conducted to explore the efficacy and safety of mecapegfilgrastim, a long-acting G-CSF, in patients with hematologic malignancies. Patients administered at least twice mecapegfilgrastim were included for statistical analysis. The baseline characteristics, effectiveness and safety results were presented. Results: Mecapegfilgrastim were administrated prophylactically in 74 patients (pts) with hematologic malignancies (Diffuse large B-cell lymphoma 34 pts, follicular lymphoma 9 pts, peripheral T-cell lymphoma 3 pts, primary mediastinal large B-cell lymphoma 3 pts, angioimmunoblastic T-cell lymphoma 3 pts, Anaplastic Large Cell Lymphoma 3 pts, classic Hodgkin's lymphoma 3 pts, other lymphomas 12 pts, other hematologic malignancies 4 pts). The median age of pts was 58 years. The ECOG performance score were 0 -2. Common chemotherapy regimens were CHOP, CHOEP, DHAP and GemOx. Rituximab, anti-PD-1 antibody, BTK inhibitors, chidamide and lenalidomide were the most administrated targeted or immunotherapeutic agents. In all 250 treatment cycles (61 chemotherapy cycles and 189 immunochemotherapy), twenty-seven pts had grade ≥3 neutropenia in 41 (16.4 %) cycles, fifteen pts had grade 4 neutropenia in 22(8.8 %) cycles, four pts experienced febrile neutropenia in 4 (1.6 %) cycles. In 61 chemo-alone treatment cycles, grade 3/4 neutropenia was reported in 10(16.4%) and, 4 (4.9 %) cycles, febrile neutropenia was recorded in 2(3.3 %) cycles. During 189 cycles of immunochemotherapy treatment, grade 3/4 neutropenia and febrile neutropenia was observed in 31(16.4%), 18(9.5 %) and 2(1.1 %) cycles, respectively. There were 5 cycles of grade 4 neutropenia occurred in 9 lenalidomide contained treatment cycles, and febrile neutropenia was reported in 1 cycle. Grade ≥ 3 neutropenia induced treatment delay (≥ 7 days) was reported in 12 cycles while dose of cytotoxic drugs were not decreased. Eleven pts developed infection including 6 pneumonia events, they were treated with antibiotics in 23 cycles. Adverse event (AE) was reported in 64(86.6 %) pts. Fourteen (18.9 %) pts were hospitalized due to AEs. Most common grade 1/2 AEs related to mecapegfilgrastim were leucocytosis (18.9%) and neutrocytosis (6.8 %). Conclusion: Mecapegfilgrastim showed promising effectiveness and reliable safety profile in pts with hematologic malignancies. Further investigation is warranted. Disclosures No relevant conflicts of interest to declare.

Background: Apatinib is an oral small-molecule tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 (VEGFR-2). Some clinical trials have demonstrated that apatinib is efficacious against advanced nonsquamous NSCLC. Objective: This study aimed to probe efficacy and safety of apatinib plus docetaxel, as the second or above line treatment, in advanced nonsquamous NSCLC. Design: Multicenter, prospective, single arm study. Setting: Three teaching hospitals centers in the Sichuan. Participants: Fourteen patients with stage IVA/B nonsquamous NSCLC had previously received at least 1 platinum-based chemotherapy regimen. Intervention: Patients who were enrolled between November 2016 and January 2018 were given docetaxel (75 mg/m2, i.v., d1) plus oral apatinib (250 mg/d), 4 weeks as one cycle, until disease progression or intolerance to adverse events (AE). Main outcome measures: The primary endpoint was progression-free survival (PFS). The secondary endpoints comprised objective response rate (ORR), disease control rate (DCR), overall survival (OS), and AE incidence rate. Results: All patients carried adenocarcinoma by pathological type. The median follow-up duration was 9.76 months. Out of 14 cases, 12 were evaluable, showing ORR of 33.33%, DCR of 66.67%, DCR of 50% in cases with brain metastasis, median PFS of 2.92 months (95% CI: 1.38–4.48), and 6-month OS of 80%. Primary AEs encompassed: leukopenia in 7 cases (58.33%), hand-foot skin reaction in 5 cases (41.67%), and diarrhea in 4 cases (33.33%). Among them, grade 3 AEs were: leukopenia in 4 cases (33.33%), and hand-foot skin reaction in 1 case (8.33%). No grade 4/5 AEs were reported. Univariate and multivariate analysis were conducted respectively for PFS and OS. These factors encompassed: gender, age, gene mutations, clinical stage, ECOG scores, quantity of metastatic foci, brain metastasis, and hand-foot skin reaction. Results demonstrated zero risk factors for PFS or OS. Conclusion: Apatinib plus docetaxel, as the second or above line treatment, is effective and safe against advanced nonsquamous NSCLC, with good tolerance profile. Trial registration: NCT03416231.

e24072 Background: The prophylaxis of neutropenia has been evolving from short acting granulocyte colony-stimulating factors (G-CSFs) to long acting G-CSFs. The safety and effectiveness of long acting G-CSF in a real-world setting were still lacking. Methods: We performed a multi-center, non-interventional, real-world study to explore the tolerability and effectiveness of mecapegfilgrastim. Different prophylactic strategy (primary or secondary prophylaxis) were compared. The effect of mecapegfilgrastim by means of continuous administration was also explored. Results: This study included 638 patients who had complete the study from May 2019 to November 15, 2020. About half of the participants were breast cancer patients. The mean age of the patients were 56 years. The most frequently reported adverse event possibly related to study drug was white blood cell increase (6.2 %). No unexpected adverse events were reported. Overall, thirty-six (5.6 %) patients experienced grade ≥ 3 neutropenia in chemotherapy cycle one. The patients in the primary and secondary prophylaxis subgroups had incidence of grade ≥ 3 neutropenia of 4.3 % and 9.2 % in chemotherapy cycle one respectively. There was a decreasing trend of neutropenia from cycle one to cycle four when mecapegfilgrastim were administrated continuously. Conclusions: The mecapegfilgrastim was well tolerable and no unexpected adverse events were observed in real-world setting. Primary prophylaxis using mecapegfilgrastim had lower incidence of neutropenia than secondary usage.

e21213Background: There is no effective treatment strategy for patients with advanced non-small cell lung cancer (NSCLC) who experienced progression with one or two lines of chemotherapy. Apatinib,...