Indications
Trilaciclib is used in adults with extensive-stage small cell lung cancer. It is given shortly before certain chemotherapy treatments to reduce the damage that chemotherapy does to the bone marrow (myelosuppression). This can lower the chance of low white cell counts, anaemia and the need for blood transfusions or growth factor injections. It is not a treatment for the cancer itself.
How It Works
Trilaciclib is a short-acting inhibitor of enzymes called cyclin-dependent kinases 4 and 6 (CDK4/6). It briefly pauses the bone marrow stem cells in a resting phase of the cell cycle while the chemotherapy is in the blood. Because chemotherapy mainly harms dividing cells, these resting marrow cells are better protected, while small cell lung cancer cells, which do not depend on CDK4/6, are still affected by the chemotherapy.
Dosage and Administration
Trilaciclib is given by a doctor or nurse in hospital as a 30-minute infusion into a vein, finished within 4 hours before chemotherapy starts on each chemotherapy day. The dose is based on body surface area and is as prescribed by the oncologist.
Interactions
- Trilaciclib can raise blood levels of medicines removed by the kidney transporters OCT2 and MATE, such as Dofetilide, Dalfampridine and Cisplatin; using it with Dofetilide or Dalfampridine is not advised because of heart or seizure risks, and patients on Cisplatin are monitored closely.
- Tell the medical team about all other medicines and supplements.
Contraindications
Do not use if you have had a severe allergic reaction to Trilaciclib or any ingredient of the product.
Side Effects
Common side effects include tiredness, headache, low calcium, potassium or phosphate in the blood, raised liver enzymes, and pain, swelling or redness along the vein used for the drip (phlebitis). Rarely it can cause inflammation of the lungs (interstitial lung disease or pneumonitis) or a severe allergic reaction. Chemotherapy side effects still occur.
Get urgent medical help if you have new or worsening cough, breathlessness or chest pain, swelling of the face or throat, difficulty breathing, severe pain or hardness along the vein, or fever with chills.
Pregnancy and Lactation
Trilaciclib may harm an unborn baby. Women who could become pregnant should use effective contraception during treatment and for at least 3 weeks after the last dose. Do not breastfeed during treatment and for at least 3 weeks after the last dose. The chemotherapy given with it also has its own pregnancy warnings.
Precautions and Warnings
- The infusion site is checked for vein irritation; the drip may be slowed or flushed.
- Blood electrolytes and liver tests are monitored.
- Report any new breathing symptoms promptly.
Overdose
Because it is given in hospital, overdose is unlikely. If it happens, the patient is monitored and treated for symptoms. There is no specific antidote.
Therapeutic Class
Myeloprotective agent; cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor.
Storage
Store unopened vials as directed on the pack, usually below 25°C, protected from light. It is stored and prepared by hospital staff.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.