Guideline Video

Guideline Resources

  • Febrile Neutropenia in Patients Treated with Chemotherapy/Immune Checkpoint Inhibition
  • Multinational Association of Supportive Care in Cancer
  • July 29, 2026
  • Summary
  • Full-text

Video Transcription

Just published July 29th, 2026, the Multinational Association of Supportive Care in Cancer’s newest consensus statement on Febrile Neutropenia in Patients Treated with Chemotherapy/Immune Checkpoint Inhibition.

This consensus statement considers the challenges of managing patients with febrile neutropenia treated with combined chemotherapy/immune checkpoint inhibitor (ICI) therapy.  It considers the suitability of managing patients with potentially low-risk febrile neutropenia treated with these regimens in an ambulatory emergency setting or other non-hospital-based acute settings.

In today’s rapid update, we’ll just be going over a summary of the position points so for the full consensus statement, make sure to check it out on guidelinecentral.com

Let’s get started. 

  • Increasing numbers of emergency presentations in cancer patients means alternative pathways, such as outpatient ambulatory emergency care, are required to ensure sustainable services and improve outcomes
  • Risk stratifying patients with febrile neutropenia as high or low risk is essential to personalise acute management and optimise use of healthcare resources
  • The Multinational Association of Supportive Care in Cancer (MASCC) score is a well-validated score for risk stratification in febrile neutropenia and patients with a score≥21 are likely to be suitable for outpatient or ambulatory emergency care
  • There is a lack of prospective and real-world data in the management of toxicities from newer regimens, such as combined chemotherapy/immune checkpoint inhibition
  • Patients treated with chemotherapy/ICI presenting with febrile neutropenia and a MASCC risk index<21 are high risk and require standard neutropenic sepsis management
  • Patients treated with chemotherapy/ICI therapy with low-risk febrile neutropenia should be treated on the same pathway as those treated with chemotherapy alone with inclusion criteria adapted to recognise their eligibility if required
  • Empirical usage of high-dose steroids in patients presenting with febrile neutropenia on chemo/ICI therapy with grade≥3 diarrhoea and/or transaminitis should be carefully balanced against the severity of sepsis, need of investigation for infective pathogens and clinical suspicion that presentation is ICI mediated
  • ICI-mediated neutropenia should be considered in patients receiving combined chemotherapy/ICI therapy when the timing of presentation is unanticipated or there is a failure of neutrophil recovery with persistent grade 3/4 neutropenia 10 days following administration
  • Initial treatment of suspected ICI-mediated neutropenia is to commence high-dose steroids and consider short-acting G-CSF
  • Telemedicine and provision of remote monitoring using patient-reported outcome measures  are increasingly important adjuncts to acute ambulatory cancer management programmes, such as low-risk febrile neutropenia

And there you have it. Make sure to check out the full consensus statement from the Multinational Association of Supportive Care in Cancer and other related clinical decision support tools at guidelinecentral.com.

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