Interventions of Interest:

  • plinabulin (BeyondSpring Pharmaceuticals)
  • trilaciclib (Cosela™, G1 Therapeutics)

Until recently, cytotoxic chemotherapy was the primary form of chemotherapy used to treat cancer, and it remains in widespread use today. Because it targets rapidly dividing cells, one of the common side effects of cytotoxic chemotherapy is low blood cell counts (myelosuppression), including low neutrophil counts (neutropenia), low platelet counts (thrombocytopenia), and low red blood cell counts (anemia).

Neutropenia in particular puts patients at high risk for infection. When patients with severe neutropenia develop a fever (febrile neutropenia), they are frequently hospitalized and treated with broad spectrum antibiotics for presumed infections. In response to severe neutropenia, oncologists may reduce the dose and/or frequency of chemotherapy. This can result in lower overall survival, particularly when chemotherapy is being used with the intent to cure the patient. In addition, the cost of hospitalizations for neutropenia is high. For example, in the United States in 2012, there were over 100,000 hospitalizations for chemotherapy-associated neutropenia at a total cost of $2.7 billion.

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