Should thrombopoietin receptor agonists be used for chemotherapy-induced thrombocytopenia?

Chemotherapy-induced thrombocytopenia (CIT) is a common complication of cancer therapy for solid tumors that results in increased bleeding risk and chemotherapy dose reductions, treatment delays, and agent discontinuation. Unlike other chemotherapy-induced cytopenias, CIT remains without any licensed therapies in most of the world. Multiple thrombopoietin receptor agonists (TPO-RAs) have been approved for other thrombocytopenic indications, however, and are widely available, offering an accessible option for CIT management. In this Research and Practice in Thrombosis and Haemostasis Forum article, the historical reasons for the current state of CIT treatment are explained, the potential benefits and risks of TPO-RA use in CIT are discussed, and the patient populations who are likely to benefit and not benefit from TPO-RA support are described.