tislelizumab + cisplatin + gemcitabine + trilaciclib

This is a combination regimen consisting of four drugs: - **Tislelizumab** is a humanized IgG4 monoclonal antibody that targets programmed death receptor 1 (PD-1), blocking its interaction with PD-L1 and PD-L2 to restore T-cell function and promote immune-mediated antitumor activity. Developed by BeiGene, it is approved in several indications including urothelial carcinoma and esophageal squamous cell carcinoma[6][9]. - **Cisplatin** is a platinum-based chemotherapy agent that forms DNA crosslinks, leading to apoptosis of rapidly dividing cells. - **Gemcitabine** is a nucleoside analog used as chemotherapy; it inhibits DNA synthesis by incorporation into DNA strands during replication. - **Trilaciclib** is an intravenous cyclin-dependent kinase 4/6 (CDK4/6) inhibitor developed by G1 Therapeutics; it transiently arrests hematopoietic stem/progenitor cells in the G1 phase to protect them from chemotherapy-induced damage. The three-drug combination of tislelizumab, cisplatin, and gemcitabine has been studied extensively as first-line or adjuvant therapy for muscle-invasive urothelial carcinoma (MIUC), upper tract urothelial carcinoma (UTUC), and metastatic bladder cancer[1][2][3][4][8]. The addition of trilaciclib aims to reduce myelosuppression caused by cytotoxic agents but has not been widely reported in published clinical trials with this exact quadruple regimen.

Brand names

TevimbraCosela

Other names

TGC (for tislelizumab, gemcitabine, and cisplatin in some studies)