Pharmacist Medication Insights: Trilaciclib for Myelosuppression

Trilaciclib (Cosela) is indicated to reduce the frequency of chemotherapy-induced bone marrow suppression in adults receiving certain types of chemotherapy for extensive-stage small cell lung cancer.

In February 2021, the FDA approved trilaciclib (Cosela) to reduce the frequency of chemotherapy-induced bone marrow suppression in adults receiving certain types of chemotherapy for extensive-stage small cell lung cancer (ES-SCLC).

Trilaciclib was evaluated in 3 double-blind, placebo-controlled phase 2 trials in adult patients with ES-SCLC: G1T28-02 (NCT02499770), G1T28-05 (NCT03041311), and G1T28-03 (NCT02514447).2-4 In an analysis presented during the 2020 ASCO Virtual Scientific Program, investigators examined the pooled data from these trials to characterize the myelopreservation effects of the CDK4/6 inhibitor.

G1T28-02 evaluated the clinical benefit of trilaciclib in preserving the bone marrow and the immune system while augmenting the antitumor activity of chemotherapy when given before carboplatin and etoposide in the first-line treatment of patients with newly diagnosed disease.

In this trial, patients were administered either trilaciclib or placebo on days 1 through 3 of each 21-day cycle. In G1T28-05, investigators evaluated the potential benefit of the CDK4/6 inhibitor in preserving bone marrow and the immune system while encouraging antitumor efficacy when given with carboplatin, etoposide, and atezolizumab (Tecentriq) in the frontline treatment of patients with newly diagnosed disease.