Cosela May Help Prevent Side Effects from Breast Cancer Treatment

Cosela (trilaciclib) was shown to reduce side effects from Trodelvy (sacituzumab govitecan-hziy) — an antibody drug conjugate — in patients with unresectable locally advanced or metastatic triple-negative breast cancer, according to initial data from the ongoing phase 2 ASCENT clinical trial.

Researchers compared data of treatment-related side effects between the 258 patients who received Trodelvy alone to the 18 patients who received Cosela before treatment with Trodelvy.

Cosela was previously approved by the Food and Drug Administration in February 2021 to prevent chemotherapy-induced bone marrow suppression in patients with lung cancer.

Findings showed that patients who were given Cosela had a lower instance of fatigue of any severity than those who did not (44% versus 52%, respectively); nausea (39% versus 62%); constipation (28% versus 37%); diarrhea (28% versus 65%); neutropenia (decrease in a type of white blood cell; 22% versus 64%); decreased appetite (22% versus 28%). Further, there were no severe instances of fatigue, nausea, constipation, diarrhea, headache or decreased appetite in the Cosela group.

Patients in the Cosela group also had a lower instance of blood-related side effects, such as anemia (low level of hemoglobin, a type of red blood cell; 6% versus 34%); febrile neutropenia (fever and decreased neutrophils, a type of white blood cell; 0% versus 6%); and thrombocytopenia (decrease in thrombocytes, a type of white blood cell; 0% versus 5%). There were no severe instances of these side effects for patients given Cosela, where in the Trodelvy-only group, 8%, 6% and 2% experienced severe anemia, febrile neutropenia and thrombocytopenia, respectively.

“Though the data are preliminary, we are seeing encouraging and consistent reductions in the rate of adverse events related to use of (Trodelvy) when (Cosela) is administered prior to the (antibody drug conjugate), relative to the previously published single agent safety profile of this (antibody drug conjugate), including those related to myelosuppression,” said Dr. Raj Malik, chief medical officer at G1 Therapeutics, the manufacturer of Cosela, in a company-issued press release.

Malik explained that the Cosela-Trodelvy combination will continue to be studied in the ASCENT trial, and more comprehensive data are expected to be presented mid-2023.

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