Granulocyte colony-stimulating factor in lung cancer

Hematopoietic growth factors, specifically G-CSF and GM-CSF, have proved to be effective in abrogating myelosuppression associated with cytotoxic chemotherapy. Both G-CSF and GM-CSF have been well tolerated although GM-CSF has been associated with more thrombocytopenia and a first dose reaction consisting of dyspnea, hypotension and tachycardia. G-CSF has clearly reduced the incidence of infection as manifested by fever during neutropenia in two placebo controlled prospective trials. Similar data are lacking for GM-CSF. Neither growth factor seems to have a clinically significant direct effect on lung cancer growth. However, further studies are necessary to clarify this issue given the conflicting in vitro data concerning growth stimulation. Further study also is needed to ascertain what impact, if any, the hematopoietic protective effect has on response and survival.