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Chemotherapy-induced myelosupression (CIM) is the most common toxicity of chemotherapy drugs. Usually, more than 80% of chemotherapy drugs lead to myelosuppression, and CIM is usually characterized by neutropenia, thrombocytopenia and erythrocytopenia. Dose reduction and delayed administration of chemotherapy drugs by CIM seriously reduce the life quality of patients and the overall anti-tumor effect of chemotherapy. As the first drug approved for bone marrow protection, trilaciclib is a highly effective, selective and reversible cyclin-dependent kinase (CDK) 4/6 inhibitor, which can temporarily block cell cycle of hematopoietic stem/progenitor cells and immune cells in G1 phase, so as to reduce the damage caused by chemotherapy and protect bone marrow protection. In April 2021, trilaciclib was approved by FDA as a myelo preservation in the United States. In July 2022, trilaciclib was approved by the National Medical Products Administration for marketing in China, and the first indication of trilaciclib in China was for patients with extensive stage small-cell lung cancer. In this review, the mechanisms of action, pharmacokinetics, drug interaction mechanism, clinical evaluation, safety and other related research progress of trilaciclib are systematically reviewed, aiming to provide further reference and basis for clinical practice.

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骨髓抑制(chemotherapy-induced myelosupression, CIM)是化疗药物最常见的毒性反应,80%以上的化疗药物都会导致CIM。CIM通常表现为中性粒细胞、血小板及红细胞减少等。CIM会导致化疗药物减量、延迟给药,严重影响肿瘤患者的生活质量,降低化疗的整体抗肿瘤效果。作为全球首个具有全系骨髓保护作用的药物,曲拉西利是一种高效、选择性、可逆的细胞周期蛋白依赖性激酶(cyclin-dependent kinase, CDK)4/6抑制剂,可将造血干细胞和祖细胞、免疫细胞等细胞周期短暂阻滞在DNA合成前期(G1期),以降低化疗引起的损伤,从而发挥骨髓保护及免疫调节的作用。2021年4月,曲拉西利在美国获批上市。2022年7月,曲拉西利在我国获批上市,首个获批适应证为“适用于既往未接受过系统性化疗的广泛期小细胞肺癌患者,在接受含铂类药物联合依托泊苷方案治疗前预防性给药,以降低化疗引起的CIM的发生率”。本文拟对曲拉西利的作用机制、药动学、药物相互作用机制、临床评价及安全性等相关研究进展进行系统阐述,以期为临床实践提供进一步的参考及依据。

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周建英,女,主任医师,主要从事肿瘤、肺部感染性疾病相关诊断及治疗。E-mail:
陈培锋,男,主任医师,主要从事肺癌相关诊断及治疗。E-mail:
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钱敏佳,女,副主任医师,主要从事肺癌相关诊断及治疗。E-mail:

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曲拉西利用于骨髓保护的作用机制及临床研究进展
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钱敏佳 1, 2 , 金戈 2 , 傅玲玲 2 , 许敏 2 , 陈何健 2 , 周建英 1 , 陈培锋 2
中国新药杂志 | 肿瘤治疗相关骨髓抑制防治进展专题 2023,32(23): 2339-2346
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中国新药杂志 | 肿瘤治疗相关骨髓抑制防治进展专题 2023, 32(23): 2339-2346
曲拉西利用于骨髓保护的作用机制及临床研究进展
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钱敏佳1, 2 , 金戈2, 傅玲玲2, 许敏2, 陈何健2, 周建英1 , 陈培锋2
作者信息
  • 1浙江大学医学院附属第一医院呼吸与危重症医学科,杭州 310003
  • 2浙江省诸暨市人民医院呼吸与危重症医学科,诸暨 311800
  • 钱敏佳,女,副主任医师,主要从事肺癌相关诊断及治疗。E-mail:

通讯作者:

周建英,女,主任医师,主要从事肿瘤、肺部感染性疾病相关诊断及治疗。E-mail:
陈培锋,男,主任医师,主要从事肺癌相关诊断及治疗。E-mail:
Mechanism of action and clinical research progress of trilaciclib in bone marrow protection
Min-jia QIAN1, 2 , Ge JIN2, Ling-ling FU2, Min XU2, He-jian CHEN2, Jian-ying ZHOU1 , Pei-feng CHEN2
Affiliations
  • 1Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 31003, China
  • 2Department of Respiratory and Critical Care Medicine, Zhuji People's Hospital of Zhejiang Province, Zhuji 311800, China
出版时间: 2023-12-15
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骨髓抑制(chemotherapy-induced myelosupression, CIM)是化疗药物最常见的毒性反应,80%以上的化疗药物都会导致CIM。CIM通常表现为中性粒细胞、血小板及红细胞减少等。CIM会导致化疗药物减量、延迟给药,严重影响肿瘤患者的生活质量,降低化疗的整体抗肿瘤效果。作为全球首个具有全系骨髓保护作用的药物,曲拉西利是一种高效、选择性、可逆的细胞周期蛋白依赖性激酶(cyclin-dependent kinase, CDK)4/6抑制剂,可将造血干细胞和祖细胞、免疫细胞等细胞周期短暂阻滞在DNA合成前期(G1期),以降低化疗引起的损伤,从而发挥骨髓保护及免疫调节的作用。2021年4月,曲拉西利在美国获批上市。2022年7月,曲拉西利在我国获批上市,首个获批适应证为“适用于既往未接受过系统性化疗的广泛期小细胞肺癌患者,在接受含铂类药物联合依托泊苷方案治疗前预防性给药,以降低化疗引起的CIM的发生率”。本文拟对曲拉西利的作用机制、药动学、药物相互作用机制、临床评价及安全性等相关研究进展进行系统阐述,以期为临床实践提供进一步的参考及依据。

骨髓抑制  /  化疗药物  /  曲拉西利  /  免疫调节  /  生存获益

Chemotherapy-induced myelosupression (CIM) is the most common toxicity of chemotherapy drugs. Usually, more than 80% of chemotherapy drugs lead to myelosuppression, and CIM is usually characterized by neutropenia, thrombocytopenia and erythrocytopenia. Dose reduction and delayed administration of chemotherapy drugs by CIM seriously reduce the life quality of patients and the overall anti-tumor effect of chemotherapy. As the first drug approved for bone marrow protection, trilaciclib is a highly effective, selective and reversible cyclin-dependent kinase (CDK) 4/6 inhibitor, which can temporarily block cell cycle of hematopoietic stem/progenitor cells and immune cells in G1 phase, so as to reduce the damage caused by chemotherapy and protect bone marrow protection. In April 2021, trilaciclib was approved by FDA as a myelo preservation in the United States. In July 2022, trilaciclib was approved by the National Medical Products Administration for marketing in China, and the first indication of trilaciclib in China was for patients with extensive stage small-cell lung cancer. In this review, the mechanisms of action, pharmacokinetics, drug interaction mechanism, clinical evaluation, safety and other related research progress of trilaciclib are systematically reviewed, aiming to provide further reference and basis for clinical practice.

chemotherapy-induced myelosupression  /  chemotherapy drugs  /  trilaciclib  /  immune regulation  /  survival benefit
钱敏佳, 金戈, 傅玲玲, 许敏, 陈何健, 周建英, 陈培锋. 曲拉西利用于骨髓保护的作用机制及临床研究进展. 中国新药杂志, 2023 , 32 (23) : 2339 -2346 .
Min-jia QIAN, Ge JIN, Ling-ling FU, Min XU, He-jian CHEN, Jian-ying ZHOU, Pei-feng CHEN. Mechanism of action and clinical research progress of trilaciclib in bone marrow protection[J]. Chinese Journal of New Drugs, 2023 , 32 (23) : 2339 -2346 .
  • 绍兴市卫生健康科技项目:缺氧条件下AQP9通过调节下游通路调控NSCLC恶性表型的分子机制(2022KY095)
2023年第32卷第23期
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  • 首发时间:2026-03-05
  • 出版时间:2023-12-15
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  • 录用日期:2023-09-20
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绍兴市卫生健康科技项目:缺氧条件下AQP9通过调节下游通路调控NSCLC恶性表型的分子机制(2022KY095)
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    1浙江大学医学院附属第一医院呼吸与危重症医学科,杭州 310003
    2浙江省诸暨市人民医院呼吸与危重症医学科,诸暨 311800

通讯作者:

周建英,女,主任医师,主要从事肿瘤、肺部感染性疾病相关诊断及治疗。E-mail:
陈培锋,男,主任医师,主要从事肺癌相关诊断及治疗。E-mail:
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2种不同金属材料的力学参数

Family
属数
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种数
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占总种数比例
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Genus
种数
Number of
species
占总种数比例
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species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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