Indications
Trilaciclib is used in adults with extensive-stage small cell lung cancer (ES-SCLC) to lower the chance of chemotherapy-induced myelosuppression. It is given before a chemotherapy regimen that contains a platinum drug and etoposide, or before a regimen that contains topotecan.
⚠️ Always consult a registered physician before taking any medicine.
Pharmacology
Trilaciclib is a transient inhibitor of CDK 4 and 6. Hematopoietic stem and progenitor cells (HSPCs) in the bone marrow give rise to the circulating neutrophils, RBCs and platelets, and these cells need CDK4/6 activity to multiply.
Bone Marrow:
In healthy subjects, a single dose of Trilaciclib 96 or 192 mg/m2 (0.4 or 0.8 times the approved recommended dose) slowed the proliferation of CD45+/CD3+ lymphocytes, and the effect grew with the dose. After a single dose of 192 mg/m2 (0.8 times the approved recommended dose), the percentage of cells held in G1 went up in every bone marrow progenitor subset that was checked, and this lasted up to 32 hours after the infusion. The subsets were hematopoietic stem cell/multipotent progenitor, oligopotent progenitor, monocyte lineage, granulocyte lineage, erythroid lineage and megakaryocyte lineage. By 32 hours after the dose, the total bone marrow had partly recovered and the progenitor subsets had started to proliferate again. This temporary G1 arrest of the hematopoietic stem cells contributed to the myeloprotective effect of Trilaciclib.
Cardiac Electrophysiology:
Trilaciclib is associated with an increase in the QTc interval that depends on the dose and appears after a delay. The mechanism behind this delayed QT effect is unknown. At the clinical dose of 240 mg/m2, Trilaciclib did not have a clinically relevant effect on QTc (i.e., >10 msec). QTc prolongation was seen at higher doses.
Pregnancy & Breastfeeding
Because of how Trilaciclib works, it can harm an unborn baby when given to a pregnant woman. There are no human or animal data on Trilaciclib that could show whether it raises the risk of major birth defects, miscarriage, or other problems for the mother or the baby. Pregnant women should be told about the possible risk to the baby. For the people who are given this medicine, the background risk of major birth defects and miscarriage is not known. Every pregnancy carries some background risk of birth defect, pregnancy loss, or other poor outcomes. In the general population of the United States, the background risk of major birth defects is 2% to 4%, and the risk of miscarriage is 15% to 20% of clinically recognized pregnancies.
Nothing is known about whether trilaciclib passes into human or animal milk, what it does to a breastfed child, or whether it affects milk production. Because breastfed children could have serious side effects, women who are breastfeeding should be advised not to breastfeed while taking Trilaciclib and for at least 3 weeks after the last dose.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Side Effects & Interactions
Side Effects
No side-effect data recorded yet.