Efficacy and safety of trilaciclib to prevent chemotherapy-induced myelosuppression in advanced solid tumors: a systematic review and meta-analysis
Abstract
Background: Trilaciclib is a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor that has shown promise in mitigating chemotherapy-induced myelosuppression (CIM). This meta-analysis aims to provide a comprehensive and clinically relevant quantification of trilaciclib's effectiveness in reducing CIM and its potential impact on outcomes in adult patients with solid tumors.
Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating trilaciclib administered along with chemotherapy in adult patients (≥ 18 years) with advanced or metastatic solid tumors. Databases searched included PubMed, Embase, the Cochrane Library, and major trial registries (ClinicalTrials.gov, EU Clinical Trials Register, ICTRP) up to May 21, 2025. Primary outcomes were incidence of grade 3/4 neutropenia, febrile neutropenia (FN), need for granulocyte-colony stimulating factors (G-CSF)/erythropoiesis-stimulating agents (ESA), and need for red blood cell/platelet transfusions. Efficacy endpoints included progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). Pooled odds ratios (OR) or hazard ratios (HR) were calculated using a random-effects model. Heterogeneity was assessed with the I2 statistic. Sensitivity and subgroup analyses were conducted to explore the robustness of results and sources of heterogeneity.
Results: Ten studies with a total of 979 patients were included, with 586 receiving…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 979 participants or records.
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