Stimulate Platelet Production with Romiplostim in Patients Affected with Chemotherapy-Induced Thrombocytopenia
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on April 6th, 2026
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Myelosuppression is an unintended consequence of chemotherapy, in which the bone marrow activity is hampered. This led to a significant reduction in platelet production, amongst other blood products. This condition is known as chemotherapy-induced thrombocytopenia, and there is no approved treatment for it. A study, recently published in the New England Journal of Medicine, had examined the usage of romiplostim to treat chemotherapy-induced thrombocytopenia.
Funding Source(s): Amgen
The phase 3 clinical study was conducted with 165 participants who are receiving oxaliplatin-based chemotherapy for colorectal, gastroesophageal, or pancreatic cancer. These patients were considered to be affected with chemotherapy-induced thrombocytopenia by having a platelet count of less than 85 billion platelets per liter. The majority of these patients were at stage 4 disease, with around 25% at stage 3. Around 60% of them were treated with a regimen containing 5-fluorouracil, leucovorin, and oxaliplatin, with 20% treated with apecitabine plus oxaliplatin.
The participants were randomly assigned to be treated subcutaneously with either romiplostim or placebo. Romiplostim is a peptibody with 4 domains that can bind to the receptor for thrombopoietin. This interaction would activate the platelet production process in megakaryocyte precursor cells. After around 8 weeks of treatment, the researchers found that patients treated with romiplostim have significantly higher platelet levels at 87 billion platelets per liter than those treated with placebo, at 58 billion platelets per liter.
Funding Source(s): Amgen
The phase 3 clinical study was conducted with 165 participants who are receiving oxaliplatin-based chemotherapy for colorectal, gastroesophageal, or pancreatic cancer. These patients were considered to be affected with chemotherapy-induced thrombocytopenia by having a platelet count of less than 85 billion platelets per liter. The majority of these patients were at stage 4 disease, with around 25% at stage 3. Around 60% of them were treated with a regimen containing 5-fluorouracil, leucovorin, and oxaliplatin, with 20% treated with apecitabine plus oxaliplatin.
The participants were randomly assigned to be treated subcutaneously with either romiplostim or placebo. Romiplostim is a peptibody with 4 domains that can bind to the receptor for thrombopoietin. This interaction would activate the platelet production process in megakaryocyte precursor cells. After around 8 weeks of treatment, the researchers found that patients treated with romiplostim have significantly higher platelet levels at 87 billion platelets per liter than those treated with placebo, at 58 billion platelets per liter.