Service of Pneumo-Oncology, Pneumology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
Support Care Cancer. 2022 Sep;30(9):7057-7060. doi: 10.1007/s00520-022-07084-5. Epub 2022 Apr 28.
Chemotherapy is the backbone of the treatment of several solid tumours and lymphomas. Myelotoxicity is often a dose-limiting toxicity and myeloprotection has always been investigated. In fact, over the years, several approaches have been studied in order to reduce the incidence of haematological toxicities and allow patients to receive effective, full-dose, chemotherapy. After the use of stimulating factors, such as granulocyte colony-stimulating factors and erythropoiesis-stimulating agents, in the very last years, a new approach has emerged. Trilaciclib, a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor, has been studied and it has been demonstrated in several clinical trials to reduce the incidence of myelotoxicity in small-cell lung cancer patients treated with chemotherapy or chemo-immunotherapy. Its potential role has not been fully studied yet, but it represents a highly effective tool to reduce myelotoxicity, widen the applicability of full-dose chemotherapy, even in frailer patients, and finally to increase the efficacy of chemotherapy in those tumours where relative dose intensity is a standard to achieve to get the best clinical results.
化疗是治疗多种实体瘤和淋巴瘤的基础。骨髓抑制通常是剂量限制毒性，因此一直都在进行骨髓保护的研究。事实上，多年来，为了降低血液学毒性的发生率并使患者能够接受有效、全剂量的化疗，已经研究了几种方法。在过去几年中，除了使用粒细胞集落刺激因子和红细胞生成刺激剂等刺激因子外，还出现了一种新方法。三氯氰胺，一种细胞周期蛋白依赖性激酶 4 和 6（CDK4/6）抑制剂，已在多项临床试验中进行了研究，结果表明它可降低化疗或化疗免疫治疗的小细胞肺癌患者发生骨髓抑制的发生率。其潜在作用尚未得到充分研究，但它是一种非常有效的降低骨髓抑制的工具，可扩大全剂量化疗的适用性，即使在体质较弱的患者中也是如此，最终还可提高那些相对剂量强度是获得最佳临床效果的标准的肿瘤的化疗疗效。
