Eltrombopag for Chemotherapy-Induced Thrombocytopenia: A Multicenter Retrospective Real-World Study

Area of Science:

• Oncology
• Hematology
• Pharmacology

Background:

• Chemotherapy-induced thrombocytopenia (CIT) is a significant dose-limiting toxicity, impacting cancer treatment continuity.
• Currently, no pharmacologic therapy is formally approved for managing CIT.
• Thrombopoietin receptor agonists (TPO-RAs) show potential for targeted supportive care in CIT.

Purpose of the Study:

• To evaluate the effectiveness and safety of eltrombopag in routine clinical practice for managing CIT.
• To assess the impact of eltrombopag on platelet counts and chemotherapy continuity.
• To identify adverse events associated with eltrombopag use in CIT patients.

Main Methods:

• Retrospective, single-arm, multicenter cohort study involving 31 adult patients with solid tumors.
• Tracking of platelet counts and chemotherapy continuity from baseline to week 12 post-eltrombopag initiation.
• Recording of bleeding, thrombosis, and laboratory safety signals.

Main Results:

• Median platelet count increased from 33 × 10^9/L at baseline to 99.5 × 10^9/L by week 12.
• 58.1% of patients resumed chemotherapy within 3 weeks; 48.4% completed planned regimens by week 6.
• Adverse events were limited to mild transaminase elevations; no major bleeding or thrombotic events occurred.

Conclusions:

• Eltrombopag demonstrated rapid platelet recovery and improved chemotherapy deliverability in a real-world CIT cohort.
• The safety profile of eltrombopag in this study was acceptable.
• Observational data suggest the need for prospective controlled trials to define the clinical role and optimal use of oral TPO-RAs in CIT.