Supportive care - Present use of biologicals in supportive care

Dose and schedule are important factors in the therapy of cancer. Animal model and clinical data show that there is a significant correlation between dose-intensity and survival; moreover, the shortening of interval between chemotherapy cycles prevents from tumor regrowth and maximize the effect of chemotherapy on cancer cells (Gregory SA, Trumper L, 2005). Most of anti-cancer drugs are non-selective and act indiscriminately on dividing cells. Hematological toxicity is one of the most important limiting factor for the protocols that are based on the dose-escalation or the dose-density of chemotherapy. This result in peripheral blood cytopenia (neutropenia, anemia and thrombocytopenia), higher transfusion requirement, severe infectious complications, prolonged hospitalization and higher health care expenses. The use of hematopoietic growth factors such as the granulocyte colony-stimulating factors (G-CSF) filgrastim or lenograstim and erithropoietin represented a step forward to reduce the hematological toxicity of high-dose chemotherapy and to manage the frequent infectious complications.