Recombinant human thrombopoietin (Sunshine Pharmaceutical)

Based on real-world research, we aimed to systematically evaluate the efficacy and safety of hetrombopag for the treatment of chemotherapy-induced thrombocytopenia (CIT) in patients with solid tumors. Patients with solid tumors who developed CIT (platelet count < 100 × 10⁹/L) and were treated with hetrombopag in a single hospital between February 2022 and September 2023 were included in the study. The primary outcome was complete response rate within 14 days, defined as the proportion of patients with platelet counts of ≥100 × 10⁹/L or platelet counts increased by at least 50 × 10⁹/L from baseline. Response rate within 21 days, the incidence of chemotherapy intensity reduction, the median time of response, and adverse events were reported. A total of 73 patients met the inclusion criteria and were subsequently included in the analysis. The complete response rate within 14 days was 79.5%. Within 21 days, the complete response rate was 91.8%. The incidence of chemotherapy intensity reduction was 21.9%. The median time to platelet response was 9.0 days (95% CI, 8.3-9.7 days). The baseline platelet count of ≥ 50 × 10⁹/L and the treatment regimen of hetrombopag combined with rhTPO/rhIL-11 were identified as independent favorable prognostic factors for platelet response time. Subgroup analyses demonstrated that patients receiving combination regimen exhibited a significantly reduced median time to platelet response with baseline platelet counts of ≥50 × 10⁹/L. Safety profile showed good tolerability of hetrombopag (monotherapy or combined with rhTPO/rhIL-11) in patients. Hetrombopag may be an effective and well-tolerated treatment option for CIT in patients with solid tumors.

Transfusion-dependent non-severe aplastic anemia (TD-NSAA) is a bone marrow failure disorder with high progression risk and transfusion complications, necessitating rapidly effective therapies. Recombinant human thrombopoietin (rhTPO) stimulates megakaryocyte proliferation through a mechanism distinct from that of oral TPO receptor agonists (TPO-RAs), suggesting a potential synergistic effect in accelerating hematopoietic recovery. This study evaluated the efficacy and safety of rhTPO plus cyclosporine A (CsA) and hetrombopag in patients with TD-NSAA.

In this retrospective study, data were collected from patients with newly diagnosed TD-NSAA treated with CsA + hetrombopag + rhTPO or CsA + hetrombopag alone between July 2022 and December 2023 at our center.

Twenty-nine patients in the rhTPO group and 28 in the control group were enrolled. The overall response rates (ORRs) at 1 and 2 months were significantly higher in the rhTPO group (34.5% vs 10.7%, P = 0.033; 55.2% vs 28.6%, P = 0.042, respectively). Time to achieve OR was shorter (P = 0.035), and platelet transfusion independence rates at 2 and 3 months were higher in the rhTPO group (52.6% vs. 18.8%, P = 0.039; 63.2% vs. 25.0%, P = 0.024, respectively). No significant difference was observed between the two groups in 3/6 months ORRs or complete response rates. Adverse events were comparable between groups.

Adding rhTPO to CsA + hetrombopag improves platelet recovery and early hematologic responses, supporting its potential role in optimizing the initial management of patients with TD-NSAA.