Studies have shown that administering trilaciclib prior to chemotherapy can reduce myelosuppression and improve health-related quality of life. Jerome Goldschmidt, MD, said future studies will look at how it interacts with immunotherapy.
What is an abstract involving patients with small cell lung cancer (SCLC) doing at a meeting on hematology?
As Jerome Goldschmidt, MD, an oncologist at Blue Ridge Cancer Care, in Blacksburg, Virginia, explained, the findings aren’t about SCLC per se, but about managing common hematological adverse events (HAEs) that can occur when patients are treated with chemotherapy. Many patients experience anemia, neutropenia, and thrombocytopenia, and managing these events—or better yet, preventing them—is key to patients staying on the recommended dose of therapy and avoiding AEs that lead to costly hospital stays.
Goldschmidt served as principal investigator for a retrospective, observational study conducted with Ontada, the oncology real-world data and evidence, clinical education, and technology business of The US Oncology Network, which includes Blue Ridge Cancer Care. Their findings were presented during the 2021 American Society of Hematology Annual Meeting & Exposition.1
Investigators used iKnowMed electronic health record data from January 1, 2015, through January 31, 2020, to identify patients for the study. Goldschmidt said that about 1400 patients fit the overall inclusion criteria, and patients were then divided into 2 groups: those who had experienced a grade ≥3 HAE and those who had not. Investigators found that 778 patients experienced a grade ≥3 HAE during that period. “That’s a majority of the patients,” Goldschmidt said in an interview with Evidence-Based Oncology™ during the meeting in Atlanta.
Digging deeper, the analysis showed that myelosuppression HAEs in extensive-stage SCLC bring a heavy burden in the community oncology setting. “We looked at the burden on patients, which translated into transfusions, missed doses, dose reductions, and lower dose intensity,” Goldschmidt said. All of these were higher in patients with grade ≥3 AEs.
Health care costs were higher, too. Goldschmidt noted that the study calculated the differences in outpatient costs only, and they were still substantial. “Our hypothesis was that there would be more health care utilization if you had these adverse events. And indeed, that’s what we showed,” he said.
Health outcomes data from the Ontada analysis showed the following:
Cost of care data underscore the burden of grade ≥3 HAEs:
Goldschmidt has studied the use of trilaciclib in this SCLC population. He coauthored an analysis of 3 related studies, which found that administering trilaciclib prior to chemotherapy reduces myelosuppression and improves health-related quality of life for these patients.2
“Pegfilgrastim and filgrastim are phenomenal drugs,” Goldschmidt elaborated, “but they do have their costs, their side effects, and their difficulties in delivery. Plus, they really only treat 1 cell line.” Newer therapies can prevent more hematological events in more cancers and are worth studying, he said.
“Future studies will address the benefits of trilaciclib from the standpoint of health economics, as well as relieving suffering from the patient’s end while on chemotherapy,” said Goldschmidt. “We’ll also look at how it interacts with immunotherapy,” as well as its potential benefits in other types of cancers, such as breast and colon cancer.