Abstract
AIMS: To evaluate the myeloprotective effects, safety, and survival outcomes of trilaciclib in first-line chemotherapy for extensive-stage small cell lung cancer (ES-SCLC) in China. METHODS: A single-center, retrospective study was conducted with 120 ES-SCLC patients receiving chemotherapy plus immunotherapy between January 2020 and January 2024. Patients were divided into a trilaciclib group (n = 60) and a control group (n = 60). The groups were compared for chemotherapy-related adverse effects, efficacy (ORR, DCR), and survival (PFS, OS). RESULTS: Trilaciclib significantly reduced the incidence of grade 3-4 neutropenia (18.3% vs. 66.7%, p < 0.001), grade ≥ 3 anemia (13.3% vs. 33.3%, p = 0.010), and thrombocytopenia (10.0% vs. 26.7%, p = 0.018). Median PFS was significantly longer in the trilaciclib group (6.2 vs. 4.7 months, p = 0.0139, HR = 0.6238, 95%CI 0.4474-0.9826), but no significant difference was observed in OS (15.6 vs. 13.8 months, p = 0.2399, HR = 0.8053, 95%CI 0.5577-1.163). The ORR was similar between the two groups (73.3% vs. 63.3%, p = 0.239). CONCLUSIONS: Trilaciclib demonstrates myeloprotective benefits in first-line treatment of ES-SCLC, with significant reductions in chemotherapy-related myelosuppression and improvements in treatment adherence. Although PFS was improved, no significant differences in OS or ORR were observed, indicating the need for further research with larger sample sizes to confirm its clinical efficacy.