Thrombopoietin level predicts response to treatment with romiplostim in chemotherapy‐induced thrombocytopenia

Abstract

Chemotherapy-induced thrombocytopenia (CIT) is a common complication of cancer treatment. Evidence has emerged supporting use of romiplostim to treat CIT but predicting clinical response to romiplostim is not possible. To determine utility of

Novel Perspectives on Thrombopoietin Receptor Agonists Applications

“…56,57,60 It was demonstrated that BM infiltration, prior pelvic irradiation, and prior exposure to temozolomide were predictive of non-response to ROMI, while lower TPO levels were correlated with better responses. 58,59 While ROMI was mostly utilized for CIT treatment, EP was mostly tested for CIT prevention, with available data suggesting a potential benefit. [62][63][64] Most recent studies explored avatrombopag's use for CIT management, also pointing at a potential therapeutic use.…”

“…51 Moreover, aforementioned studies proved TPO-RAs' safety and tolerability, whereas thromboembolic event rates were analogous to those historically observed in cancer patients. [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] As seen in ►Table 1, available data from trials have reported different thromboembolic event (TEE) rates, with avatrombopag yielding the lowest TEE rates. [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] It is not certain whether these differences can be solely attributed to the type of TPO-RA that has been used; however, similar results, indicating low rates of thrombosis with avatrombopag, have also been reported in patients with CLD.…”

“…[52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] As seen in ►Table 1, available data from trials have reported different thromboembolic event (TEE) rates, with avatrombopag yielding the lowest TEE rates. [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] It is not certain whether these differences can be solely attributed to the type of TPO-RA that has been used; however, similar results, indicating low rates of thrombosis with avatrombopag, have also been reported in patients with CLD. 10 Hence, based on these results, avatrombopag may seem more preferable in SOT patients.…”

“…Findings from most important studies are summarized in Table 1 . 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 Retrospective studies of ROMI's use in CIT highlighted a raise in platelet counts in the vast majority and importantly no treatment delay or discontinuation or dose reduction was observed. 53 54 55 58 59 61 In agreement, some prospective studies also indicated ROMI's efficacy and safety in this setting, with one of them reporting sustained platelet responses.…”

“…52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 Retrospective studies of ROMI's use in CIT highlighted a raise in platelet counts in the vast majority and importantly no treatment delay or discontinuation or dose reduction was observed. 53 54 55 58 59 61 In agreement, some prospective studies also indicated ROMI's efficacy and safety in this setting, with one of them reporting sustained platelet responses. 56 57 60 It was demonstrated that BM infiltration, prior pelvic irradiation, and prior exposure to temozolomide were predictive of non-response to ROMI, while lower TPO levels were correlated with better responses.…”