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NCCN Flash Updates: NCCN Guidelines Updated for Hematopoietic Growth Factors

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) and the NCCN Drugs & Biologics Compendium (NCCN Compendium^®) for Hematopoietic Growth Factors. These NCCN Guidelines^® are currently available as Version 1.2025.

Link directly to the Updates section of the NCCN Guidelines: Hematopoietic Growth Factors

Global

• FDA-approved biosimilar footnote language updated throughout: An FDA-approved biosimilar is an appropriate substitute for any recommended systemic biologic therapy in the NCCN Guidelines.

MGF-A 1 of 5

• Examples of Disease Settings and Chemotherapy Regimens with a High Risk for Febrile Neutropenia (>20%)
  • Hodgkin Lymphoma
    • Regimen added: BrECADD (brentuximab vedotin, etoposide, cyclophosphamide, doxorubicin, dacarbazine, dexamethasone)
  • Ovarian Cancer
    • Regimen added: Carboplatin/docetaxel

MGF-A 2 of 5

• Examples of Disease Settings and Chemotherapy Regimens with an Intermediate Risk for Febrile Neutropenia (10%–20%)
  • Breast Cancer
    • Regimen added: Sacituzumab govitecan-hziy
  • Ovarian Cancer
    • Carboplatin/docetaxel removed from this page and added to high risk (MGF-A 1 of 5)

MGF-A 3 of 5

• References have been updated.

MGF-B 1 of 2

• G-CSFs for Prophylaxis of Febrile Neutropenia and Maintenance of Scheduled Dose Delivery
  • Bullet 5 modified: Caution should be exercised when administering prophylactic G-CSF in patients given concurrent chemotherapy and radiation. Randomized data have indicated a detrimental effect on toxic deaths with the use of granulocyte-macrophage colony-stimulating factor (GM-CSF) during concurrent chemoradiotherapy. This was not observed in a more recent secondary analysis of the CONVERT trial, in which prophylactic G-CSF was allowed. The risks and benefits of G-CSF versus dose reduction or delay during modern chemoradiotherapy are uncertain at this time.
  • Footnote c added: Non-cytotoxic targeted therapeutics should be excluded from 24-hour recommendation.
  • Footnote f added: Pegfilgrastim administration increases bone marrow and spleen fluorodeoxyglucose (FDG) uptake, which may impact PET/CT assessment and interpretation.
  • Footnote g modified: Rarely (1.7%–6.9%), there is a failure to inject that requires further medical attention. Individuals with on-body injectors should avoid MRIs.

MGF-B 2 of 2

• References have been updated.

TGF-1

• Assessment
  • Suspected chemotherapy induced thrombocytopenia (CIT)
    • Bullet 2, sub-bullet 7 modified: Radiation- or chemotherapy-induced myelosuppression

TGF-2

• Footnote c modified: Insufficient data are available to support use of TPO-RAs other than romiplostim for CIT outside of a clinical trial. Retrospective studies have evaluated other TPO-RA agonists, including avatrombopag, but there are insufficient data from these studies to recommend these agents. Additional prospective studies are needed to determine safety, efficacy, and benefits of TPO-RA agonists.

ANEM-B 1 of 2

• Parenteral Iron Preparations
  • Ferumoxytol (in select cases)
    • Dosing regimen added: 1020 mg IV single dose over 15–30 min

ANEM-B 2 of 2

• References have been updated.

MS-1

• The Discussion section has been updated to reflect the changes in the algorithm.

 

For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium^®), the NCCN Biomarkers Compendium^®, the NCCN Chemotherapy Order Templates (NCCN Templates^®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients^®, please visit NCCN.org/patientguidelines.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.

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