Patients with extensive-stage small cell lung cancer who receive trilaciclib appear to experience lower rates of hematologic adverse effects than those who are not treated with the agent.
Real-world data suggest that treatment with trilaciclib (Cosela) prior to chemotherapy may lower the incidence of hospitalization and cytopenia events while improving survival among patients with extensive-stage small cell lung cancer (ES-SCLC), according to a news release from G1 Therapeutics, Inc.1
In a study evaluating myelosuppression events and health care resource use (HRU), 11.2% of patients treated with trilaciclib (n = 77) experienced grade 3 or higher hematologic adverse effects (HAEs) in at least 1 lineage compared with 30.7% of patients in a matched comparison cohort not treated with trilaciclib (n = 77).2 Additionally, in each respective cohort, investigators reported HAE rates of 1.2% and 13.5% in at least 2 lineages and 0.4% and 4.9% in 3 lineages. Moreover, there was a 51% reduction in all-cause hospitalization in patients treated with trilaciclib, although investigators noted this was not statistically significant.
In another study assessing real-world hospitalization rates and cytopenia-related outcomes, hospitalization within 90 days after initiating chemotherapy occurred in 21.2% of patients receiving trilaciclib (n = 132) compared with 32.1% of patients not treated with trilaciclib (n = 11,940; P <.01).3 Investigators also reported a significant reduction in the risk of febrile neutropenia in patients who received trilaciclib compared with those who did not (relative risk, 15.5%; P = .03). Additionally, the 6-month survival rate was 84.1% in the trilaciclib group compared with 72.3% in patients not treated with trilaciclib (HR, 0.63; 95% CI, 0.35-1.14; P = .13).
“The burden of chemotherapy-induced myelosuppression not only puts patients at risk for serious adverse [effects] but can also stress the health care system,” Raj Malik, MD, chief medical officer at G1 Therapeutics, said in the news release.1 “Findings from these real-world analyses demonstrate the need to protect patients from the harmful [AEs] of chemotherapy so that they can continue their treatment. Trilaciclib offers the potential to transform the treatment experience, and these new data underscore the results we’ve seen across multiple analyses showing the positive impact of proactive treatment with trilaciclib.”
According to findings from a retrospective analysis including 152 patients with ES-SCLC who received chemotherapy without trilaciclib, 63.8% experienced grade 3 or higher myelosuppressive HAEs in at least 1 lineage, 32.2% experienced grade 3 or higher HAEs in at least 2 lineages, and 10.5% had grade 3 or higher toxicities in 3 lineages.4 With respect to HRU, 76.3% of patients were treated with granulocyte colony-stimulating factor at any point, 30.3% underwent a red blood cell transfusion, and 57.9% had 1 or more inpatient admissions. Additionally, it was reported that 67.8% and 100.0% of patients had at least 1 emergency room visit and 1 or more outpatient visits, respectively.
In another study assessing the relationship between chemotherapy-induced myelosuppression risk and patient characteristics in ES-SCLC, investigators highlighted that all patients regardless of sex, race, ECOG performance status, and baseline lab values experienced a similar risk of myelosuppressive events.5 Moreover, chemotherapy intensity, prophylactic management, and treatment delays and holds correlated with a higher risk of myelosuppressive events. Overall, investigators reported that patient presentation was not necessarily associated with myelosuppression.
Investigators presented these data as posters at the 2023 American Society of Clinical Oncology (ASCO) Quality Care Symposium.