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**Trilaciclib + topotecan** is a combination regimen consisting of trilaciclib, a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor, administered prior to the chemotherapeutic agent topotecan, a topoisomerase I inhibitor. The combination is designed for use in patients with extensive-stage small cell lung cancer (ES-SCLC) who have previously received chemotherapy. The primary rationale for this combination is the "myelopreservation" effect: trilaciclib transiently arrests hematopoietic stem and progenitor cells in the G1 phase of the cell cycle to protect them from chemotherapy-induced damage, thereby reducing multi-lineage myelosuppression and improving the safety profile of topotecan chemotherapy. Clinical studies have shown this combination reduces the duration and incidence of severe neutropenia, anemia and other chemotherapy-induced cytopenias, improves patient quality of life, and maintains anti-tumor efficacy compared to topotecan alone[1][2][3][4][5].
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