Romiplostim treatment of chemotherapy-induced thrombocytopenia Journal Article

Authors: Soff, G. A.; Miao, Y.; Bendheim, G.; Batista, J.; Mones, J. V.; Parameswaran, R.; Wilkins, C. R.; Devlin, S. M.; Abou-Alfa, G. K.; Cercek, A.; Kemeny, N. E.; Sarasohn, D. M.; Mantha, S.
Article Title: Romiplostim treatment of chemotherapy-induced thrombocytopenia
Abstract: PURPOSE: Chemotherapy-induced thrombocytopenia (CIT) leads to delay or reduction in cancer treatment. There is no approved treatment. METHODS: We conducted a phase II randomized trial of romiplostim versus untreated observation in patients with solid tumors with CIT. Before enrollment, patients had platelets less than 100,000/μL for at least 4 weeks, despite delay or dose reduction of chemotherapy. Patients received weekly titrated romiplostim with a target platelet count of 100,000/μL or more, or were monitored with usual care. The primary end point was correction of platelet count within 3 weeks. Twenty-three patients were treated in a randomization phase, and an additional 37 patients were treated in a single-arm, romiplostim phase. Resumption of chemotherapy without recurrent CIT was a secondary end point. RESULTS: The mean platelet count at enrollment was 62,000/μL. In the randomization phase, 14 of 15 romiplostim-treated patients (93%) experienced correction of their platelet count within 3 weeks, compared with one of eight control patients (12.5%; P < .001). Including all romiplostim-treated patients (N = 52), the mean platelet count at 2 weeks of treatment was 141,000/μL. The mean platelet count in the eight observation patients at 3 weeks was 57,000/μL. Forty-four patients who achieved platelet correction with romiplostim resumed chemotherapy with weekly romiplostim. Only three patients (6.8%) experienced recurrent reduction or delay of chemotherapy because of isolated CIT. CONCLUSION: This prospective trial evaluated treatment of CIT with romiplostim. Romiplostim is effective in correcting CIT, and maintenance allows for resumption of chemotherapy without recurrence of CIT in most patients.
Journal Title: Journal of Clinical Oncology
Volume: 37
Issue: 31
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2019-11-01
Start Page: 2892
End Page: 2898
Language: English
DOI: 10.1200/jco.18.01931
PUBMED: 31545663
PROVIDER: scopus
PMCID: PMC6823892
Notes: Article -- Source: Scopus
Altmetric Score
MSK Authors
  1. Ghassan Abou-Alfa
    282 Abou-Alfa
  2. Gerald A Soff
    70 Soff
  3. Nancy Kemeny
    409 Kemeny
  4. Sean McCarthy Devlin
    327 Devlin
  5. Simon H Mantha
    36 Mantha
  6. Yimei   Miao
    12 Miao
  7. Jodi Victoria Mones
    9 Mones