Amgen Inc. does not expect a reduction in the use of its Neupogen G-CSF in cancer chemotherapy patients despite two studies published last week in The New England Journal of Medicine that suggest limited clinical benefit from taking the drug in two specific settings: afebrile outpatients with severe chemotherapy-induced neutropenia and children with acute lymphoblastic leukemia (ALL).

Responses to the studies from both AMGN and clinical oncologists illustrate a discrepancy between use of Neupogen as indicated on the drug's label and in published guidelines, and use of Neupogen in practice by physicians. While clinical practice may be affected by last week's studies, the small number of patients involved in that change implies that Neupogen sales will be minimally affected.