Avatrombopag for the treatment of thrombocytopenia induced by chemotherapy in patients with solid tumors: A multicenter, open-label, single-arm trial

Objective: To explore the effect and safety of avatrombopag for chemotherapy-induced thrombocytopenia (CIT). Methods: This multicenter, open-label, single-arm trial enrolled CIT patients in eight centers from October 2020 to April 2021. The participants received avatrombopag tablets 60 mg once a day for 5-10 days. The main endpoint was the proportion of patients with platelet count > 100x109/L or increased by > 50x10(9)/L or increased by > 100% in the cycle after the start of treatment. Results: Seventy-four participants were enrolled with a mean age of 59.8 +/- 11.62.2% were males. The cumulative effective rate (any criteria) was 70.3% at 4 weeks. 42 (56.8%) achieved platelet count > 100x10(9)/L, 44 (59.5%) increased by > 50x10(9)/L, and 27 (36.5%) increase by > 100% from baseline. The duration of grade III and IV platelet reduction was 4.2 +/- 5.3 days. The time of PLT recovery to > 75x10(9)/L was 9.4 +/- 6.6 days. The time of PLT recovery to > 100x10(9)/L was 10.2 +/- 6.4 days. The platelet count nadir was 57.9 +/- 45.3x10(9)/L. The most common adverse events were nausea (8.1%), fatigue (5.4%), and abdominal pain (1.4%). There were no cases of fever, headache, or peripheral edema. Conclusion: Although it was a single-arm trial without a control group, the application of avatrombopag in patients with CIT can increase the platelet count of the patients compared with baseline. Avatrombopag is safe and tolerable.