Chemotherapy-induced myelosuppression has traditionally been managed after the fact with growth factors and transfusions. Cosela (trilaciclib) introduced the idea of protecting the bone marrow before chemotherapy is even given.
Administered intravenously shortly before chemotherapy, Cosela transiently pauses the cell cycle of blood-forming stem cells so cytotoxic drugs spare them. It is approved to reduce chemotherapy-induced myelosuppression in adults receiving certain platinum/etoposide or topotecan regimens for extensive-stage small cell lung cancer.
Cosela remains the only approved myeloprotective agent of its kind and faces no generic competition. Its first-in-class proactive mechanism makes it a distinctive comparator and a molecule to monitor as myeloprotection is explored in other tumor types.
