Retrospective study of efficacy and safety of hetrombopag in treatment of chemotherapy-induced thrombocytopenia in patients with solid tumors

doi:10.16138/j.1673-6087.2025.02.05

Abstract

Abstract:

Objective To evaluate efficacy and safety of hetrombopag in the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with solid tumors. Methods From September 2021 and June 2022, patients with CIT who were treated with hetrombopag from four hospitals were enrolled. The clinical efficacy of either hetrombopag monotherapy or hetrombopag combined with recombinant human thrombopoietin (rhTPO)/ recombinant human interleukin (rhIL)-11 and the efficacy of different doses of hetrombopag were analyzed. The frequency of platelet transfusions and the incidence of adverse events were also analyzed. Results A total of 57 patients were included, in which 12 patients were in the monotherapy group (83.3% with Ⅰ-Ⅱ CIT) and 45 patients were in the combination group (64.5% with Ⅰ-Ⅱ CIT). The proportion of patients who received thrombopoietic therapy during the CIT period was significantly higher in the combination group compared to the monotherapy group (66.7% vs. 0.0%, P < 0.001). The overall responses rate was 89.5%, and responses rates at 7, 14 and 21 days after treatment were 40.4%, 77.2% and 87.7%, respectively. The responses rate was 91.7% in the monotherapy group and 88.9% in the combination group, which had no significant difference between the two groups (P = 1.000). The median peak platelet count after treatment was significantly higher in the combination group compared to the monotherapy group (151.5×10⁹/L vs. 126.0×10⁹/L, P = 0.013). In the monotherapy groups, the responses rates of 2.5 mg/d and 5 mg/d were 100.0% and 85.7%, respectively. In the combination therapy groups, the responses rates of 2.5, 5 and 7.5 mg/d were 71.4%, 91.7% and 100.0%, respectively. The response rates had no significant differences among different doses of hetrombopag in both the monotherapy and combination therapy groups (P > 0.05). After treatment, one patient need a platelet transfusion, and 4 patients in the combination group developed thrombocytosis. Conclusions Hetrombopag is effective and safe for treating CIT, in which monotherapy shows significant efficacy in mild to moderate cases, and hetrombopag combin with rhTPO or rhIL-11 is effectiveness in moderate to severe or refractory cases. However, the optimal dosage and combination regimen still need further investigation.

Key words: Hetrombopag, Chemotherapy-induced thrombocytopenia, Solid tumor, Efficacy, Safety

CLC Number:

R555

CHEN Yong, CHEN Zixuan, WU Wenjuan, WANG Xiaoqing, CHEN Xiaojun, LI Ying, WANG Rui, LI Yue. Retrospective study of efficacy and safety of hetrombopag in treatment of chemotherapy-induced thrombocytopenia in patients with solid tumors[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(02): 126-131.

Figures/Tables 3

Table 1

Table 2

Table 3

References 11

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临床特征	例数(%) （n=57）	分组		χ²/ t/ Z	P
临床特征	例数(%) （n=57）	单药组（n=12）	联合组（n=45）	χ²/ t/ Z	P
性别				4.565	0.033
男性	32（56.1）	10（83.3）	22（48.9）
女性	25（43.9）	2（16.7）	23（51.1）
年龄				1.516	0.218
<65岁	28（49.1）	4（33.3）	24（53.3）
≥65岁	29（50.9）	8（66.7）	21（46.7）
肿瘤类型				-	0.736¹⁾
消化系统	38（66.7）	9（75.0）	29（64.4）
呼吸系统	5（8.8）	1（8.3）	4（8.9）
女性生殖系统	6（10.5）	0	6（13.3）
其他	8（14.0）	2（16.7）	6（13.3）
TNM分期				-	0.817¹⁾
Ⅱ期	10（17.5）	2（16.7）	8（17.8）
Ⅲ期	6（10.5）	2（16.7）	4（8.9）
Ⅳ期	40（70.2）	8（66.7）	32（71.1）
无法分期	1（1.8）	0	1（2.2）
有无远处转移				0.000	1.000
有	40（70.2）	8（66.7）	32（71.1）
无	17（29.8）	4（33.3）	13（28.9）
治疗线数				0.000	1.000
一线	38（66.7）	8（66.7）	30（66.7）
二线及以上	19（33.3）	4（33.3）	15（33.3）
既往化疗周期				0.267	0.605
<5周期	47（82.5）	11（91.7）	36（80.0）
≥5周期	10（17.5）	1（8.3）	9（20.0）
CIT分级				-	0.651¹⁾
Ⅰ级	5（8.8）	1（8.3）	4（8.9）
Ⅱ级	34（59.6）	9（75.0）	25（55.6）
Ⅲ级	17（29.8）	2（16.7）	15（33.3）
Ⅳ级	1（1.8）	0	1（2.2）
基线血小板平均计数（×10⁹/L）	55.0±17.2	60.9±13.5	53.5±17.9	1.342	0.185
治疗前CIT中位持续时间/d	12.0（5.5,21.5）	10.0（6.25,21.75）	12.0（5.0,22.0）	-0.402	0.688
CIT持续时间内曾接受升血小板治疗	30（52.6）	0	30（66.7）	16.889	0.000

项目	所有患者（n=57）	单药组（n=12）	联合组（n=45）	χ²/ t/ Z	P
达到有效（%）	51（89.5）	11（91.7）	40（88.9）	0.000	1.000
平均治疗时长（d）	9.2±4.7	8.3±5.1	9.5±4.7	-0.756	0.453
达有效标准时的中位血小板计数（×10⁹/L）	127.0（109.0,167.0）	115.0（108.0,129.0）	132.0（109.0,180.0）	-1.741	0.082
治疗后血小板计数中位峰值（×10⁹/L）	134.0（119.0,198.0）	126.0（110.0,134.0）	151.5（126.3, 243.3）	-2.485	0.013
接受血小板输注（%）	1（1.8）	0	1（2.2）	-	1.000¹⁾
接受下周期化疗（%）	46（80.7）	9（75.0）	37（82.2）	0.023	0.879
治疗期间各时间段有效率（%）
7 d	23（40.4）	6（50.0）	17（37.8）	0.190	0.663
14 d	44（77.2）	10（83.3）	34（75.6）	0.034	0.854
21 d	50（87.7）	11（91.7）	39（86.7）	0.000	1.000

项目	单药组				联合组
项目	2.5 mg/d（n=5）	5.0 mg/d（n=7）	t/ Z	P	2.5 mg/d（n=7）	5.0 mg/d（n=36）	7.5 mg/d（n=2）	F/ Z	P
平均基线血小板计数（×10⁹/L）	63.8±7.1	58.9±16.9	0.609	0.556	50.4±18.4	54.9±17.7	39.0±22.6	0.860	0.430
中位基线CIT持续时间（d）	9.0（1.0,17.0）	19.0（7.0,22.0）	-0.895	0.371	14.0（4.0,24.0）	11.5（5.0,18.8）	27.5	3.431	0.180
达到有效的患者（%）	5（100）	6（85.7）	-	1.000^1）	5（71.4）	33（91.7）	2（100）	-	0.354¹⁾

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