illustration of how the drug protects blood cells

Myelosuppression and Small Cell Lung Cancer

There’s new protection managing extensive-stage SCLC. Trilaciclib lets you fight the cancer, not the chemotherapy.

Trilaciclib is a first-of-its-kind prescription medicine that protects against the damage caused to bone marrow cells during chemotherapy. Since bone marrow cells form red and white blood cells, trilaciclib helps patients undergoing chemotherapy by reducing the side effects that occur because of low blood cell counts.

While not a treatment for cancer, trilaciclib helps protect you from some of the most harmful effects of chemotherapy so you can stick with your treatment and improve your quality of life. Fewer side effects means returning to the things you love sooner.

Learn more about how trilaciclib helps protect red blood cells from some of the most harmful effects of chemotherapy.

Who Should Use Trilaciclib?

In February of 2021, the FDA approved trilaciclib for adults with extensive-stage small cell lung cancer (SCLC) who are receiving certain types of chemotherapies (a platinum/etoposide-containing or topotecan-containing regimen).

While only 15% of lung cancer patients have small cell lung cancer, it is difficult to treat for several reasons. One reason is that patients often do not show symptoms until the cancer has already metastasized, or spread to other parts of the body. Another reason is that it tends to grow and spread faster than non-small cell lung cancer. Finally, while small cell lung cancer responds well to initial treatments, it usually comes back more aggressively within 6 to 8 months.

This rapid progression tends to rule out more targeted therapies like radiation or immunotherapy. Because of its rapid progression, chemotherapy, which attacks fast-growing cells, remains the standard of care for small cell lung cancer.

Myelosuppression While Treating Small Cell Lung Cancer

Unfortunately, chemotherapy is not a targeted therapy. It attacks all fast-growing cells in your body, which includes harmful cancer cells, but also includes vital, healthy cells, like bone marrow cells. Chemo has many well-known side effects, such as hair loss, mouth sores, weight loss, and nausea, but one of the most common and dangerous side effects is myelosuppression, or the suppression of bone marrow activity.

Bone marrow cells produce red and white blood cells and platelets. These cells are necessary to keep our bodies working and fight off infection. The main effects of myelosuppression are anemia, neutropenia, and thrombocytopenia.

Anemia is caused by a low red blood cell count. Red blood cells carry oxygen from our lungs throughout our bodies, so anemia can result in symptoms like fatigue, weakness, dizziness, shortness of breath, and an irregular heartbeat.

Neutropenia is caused by a low white blood cell count. White blood cells fight off viruses and bacteria, and a low count will increase the risk of infection.

Thrombocytopenia is caused by a low platelet count. Since platelets stop bleeding by forming clots, thrombocytopenia can result in easy or excessive bruising or difficulty stopping bleeding.

While these three effects may be easily treated in an otherwise healthy individual, they can lead to serious infections or other complications for a patient undergoing chemotherapy. For small cell lung cancer patients, this can mean adding additional treatments to their regime and stressing the body more, or pausing chemotherapy, which could have severe consequences with such a fast-moving cancer.

What Makes Trilaciclib Different

Trilaciclib lets you fight the cancer, not the chemotherapy.

The typical interventions to treat myelosuppression work to rebuild low blood cell counts after they have been decimated by chemotherapy. These include granulocyte colony stimulating factors (G-CSFs), which helps bone marrow make more white blood cells, erythropoiesis-stimulating agents (ESAs), which enable the production of more red blood cells, and blood transfusions to increase blood platelets.

These are referred to as rescue interventions, and just like they sound, they are meant to fix a problem, not prevent it. They come with three main drawbacks:

  • they are retroactive and used after the patient has suffered from the symptoms listed above
  • each intervention only treats a single effect of myelosuppression
  • they come with side effects of their own, such as pain in the hands and feet, weakness, or kidney damage

Worse still, these are only supportive interventions. The primary way to treat chemotherapy-induced myelosuppression is by reducing or delaying doses of chemotherapy. Since time is crucial when treating small cell lung cancer, some patients are reluctant to report side effects to their doctors. This results in less than ideal care.

Trilaciclib is different because it doesn’t wait until you’re in danger. It works proactively to prevent damage from being done. Trilaciclib is an intravenous drug that you take within 4 hours before your chemo treatment. It works to protect your bone marrow cells from the most harmful side effects of chemotherapy before they even begin.

Trilaciclib works by temporarily stopping bone marrow cells from dividing during the G1 phase, or growth phase, of the cell. Since chemotherapy attacks fast-growing cells, trilaciclib helps these bone marrow cells “hide” from the chemo during the treatment cycle. This reduces the damage to bone marrow, so instead of taking time to recover, it can start producing red and white blood cells right after chemotherapy. Rather than rescue, it prevents.

This means less risk of infection and other complications from chemo and increased quality of life.

It’s a prevention, not a treatment.

Across three key studies for trilaciclib, patients with extensive-stage SCLC who received the drug before their chemotherapy treatments had fewer dose delays and reported improvements in well-being and in the symptoms and effects of anemia, such as fatigue.

The key benefits of trilaciclib include:

  • You take it the same day as your chemo, so no extra treatments or doctor visits.
  • It prevents the most harmful effect of chemotherapy before they begin.
  • It protects red and white blood cells and platelets to targets all the effects of myelosuppression at once and reduces the need for other supplemental treatments.
  • It helps you stick to your chemo regimen.

This last point is crucial for patients with extensive-stage small cell lung cancer, where the cancer has spread to other parts of the body. At this point, research has found few other options besides chemo for treatment.

Trilaciclib is a novel approach to protecting bone marrow from damage caused by chemotherapy. This makes treatment safer and more tolerable, reduces the need for rescue interventions, and improves patients’ overall quality of life. It offers prevention beforehand to prevent complications after.

If you’re a small cell lung cancer patient, talk with your doctor about including trilaciclib in your treatment regimen. Don’t stop treatment; don’t stop living.