EP. 4A: The Role of Trilaciclib in the Management of Chemotherapy-Induced Myelosuppression in SCLC

EP: 1.EP. 1: Extensive-Stage Small Cell Lung Cancer Treatment Landscape

EP: 2.EP. 2A: Treatment Challenges and Unmet Needs in Extensive-Stage Small Cell Lung Cancer

EP: 3.EP. 2B: Challenges Affecting the Management of Extensive-Stage Small Cell Lung Cancer

EP: 4.EP. 3: Management of Extensive-Stage Small Cell Lung Cancer Treatment-Related Events

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EP: 5.EP. 4A: The Role of Trilaciclib in the Management of Chemotherapy-Induced Myelosuppression in SCLC

EP: 6.EP. 4B: Considering Chemotherapy-Induced Myelosuppression and the Impact of Trilaciclib on Its Management

EP: 7.EP. 5: Clinical Trial Evidence for the Myeloprotective Benefit of Trilaciclib for Chemotherapy-Induced Myelosuppression

EP: 8.EP. 6A: Benefits of Using Trilaciclib in Patients With Extensive-Stage Small Cell Lung Cancer in Clinical Practice

EP: 9.EP. 6B: Clinical Experience With Trilaciclib in Patients With Extensive-Stage Small Cell Lung Cancer

EP: 10.EP. 7: Clinical Trial Evidence for Chemoprotectant Benefit of ALRN-6924 for Chemotherapy-Induced Myelosuppression

EP: 11.EP. 8A: Considerations for Reactive and Proactive Approaches to the Management of Chemotherapy-Induced Myelosuppression in Extensive-Stage Small Cell Lung Cancer

EP: 12.EP. 8B: Reactive and Proactive Treatment Approaches for the Management of Chemotherapy-Induced Myelosuppression

EP: 13.EP. 9A: The Rationale for CDK4/6 Inhibition in ES-SCLC and Updates on Trilaciclib Clinical Trial Data

EP: 14.EP. 10A: Impact of Trilaciclib on Chemotherapy-Induced Myelosuppression in Patients with ES-SCLC

EP: 15.Episode 10B: Impact of Trilaciclib on Chemotherapy Induced Myelosuppression (CIM) in ES-SCLC

EP: 16.Episode 11A: Effect of Trilaciclib in Patients Receiving Chemotherapy for ES-SCLC Treatment

EP: 17.Episode 11B: The Effect of Trilaciclib in Patients Receiving Chemotherapy for ES-SCLC Treatment

EP: 18.EP 12A: Managing Thrombocytopenia in Patients receiving Chemotherapy for ES-SCLC

EP: 19.EP 12B: Management of Chemotherapy Induced Myelosuppression (CIM) in ES-SCLC

One of the things we're finding is that severe hematologic toxicity in the treatment of [patients with] small cell [lung cancer] is much more common than most practitioners realize, and I can put myself in that same category when we started looking at it more concretely. Small cell [lung] cancer is [certainly] one of those cancers where chemotherapy is still the mainstay of treatment. As everyone knows now, immunotherapy is coming into the fore, and other new agents are [as well], but still for frontline treatment and for second-line treatment, we're using a lot of chemotherapy, which is significantly myelosuppressive. It leads to a lot of hematologic difficulties [that require] dose delays, transfusions, [and] that sort of thing. For many years, we've used growth factor support with agents such as filgrastim, pegfilgrastim, and all the newer versions of these things to support the neutrophil lineage.

Many patients with small cell lung cancer—since it's one of the most aggressive human tumors—will present with extensive stage disease beyond just the thorax. Those are the patients who we're treating now with first-line carboplatin/etoposide and the checkpoint inhibitor. With those patients, as I mentioned before, it's important to try and get the full doses of chemotherapy in so they can get their benefit. I have now started using trilaciclib with those patients, and I find there are several advantages to doing that. One, you may be able to avoid the use of other growth factors, which have their own [adverse] effects, such as bone aches and pain, which are common in patients receiving pegfilgrastim.

You also save the patient from having to come back to the clinic or office on an extra day. Obviously, this is a three-day treatment anyway. Many practices, including both my academic practice and my private practice, are trying to go to more biosimilar forms of pegfilgrastim, which do not come with on-body formulations, so the patient would have to return to the clinic with some expense and time taken coming back for an extra day in that. You avoid needing to do that.

You also have the potential [to] support the platelet lineage, avoid anemia, and possibly [prevent] the need for transfusions with all of that. [Regarding] possible delays, expense, and exposure to blood clots, I think there [are] a lot of potential advantages to using something that's going to give you trilineage support rather than simply thinking about giving someone an injection to try and support their neutrophils.

It's not going to change the long-term disease control rate with the cancer, but it's [potentially] going to make it easier to get full doses of treatment, which gives you at least a theoretical advantage in controlling the cancer. It's going to improve the patient's quality of life, and we found very, very few [adverse] effects from giving [intravenous] trilaciclib. Once in a while, somebody could have a slight local reaction at the site of the infusion, but [that is] fairly minimal.