Single-center experience with Romiplostim N01 for the management of severe persistent cancer therapy-induced thrombocytopenia in lung cancer

Cancer therapy-induced thrombocytopenia (CTIT) is a common complication in patients with lung cancer undergoing treatment, leading to treatment delays and dose reductions. Romiplostim N01, a thrombopoietin receptor agonist, has shown potential in managing severe persistent CTIT. This study aims to describe platelet recovery outcomes and safety associated with Romiplostim N01 for managing severe persistent CTIT in patients with lung cancer, providing real-world clinical evidence. This single-center observational study enrolled 56 patients with lung cancer who developed severe persistent CTIT and received Romiplostim N01 treatment from June 1, 2024, to February 28, 2025. Data on clinical characteristics, prior treatments, CTIT severity, and platelet recovery outcomes were retrospectively collected and analyzed. The primary endpoints were platelet recovery rates and the safety profile of Romiplostim N01. Of the 56 patients, 89.3% achieved platelet recovery to ≥100 × 10 9 /L, with a median recovery time of 16 days (range: 3–63 days). The treatment was well tolerated, with no serious adverse events. The most common adverse event was joint pain (10.7%), and thrombocytosis occurred in 26.8% of patients. No significant drug interactions or severe complications were observed. Additionally, patients received concomitant supportive therapies, such as platelet transfusions or oral thrombopoietin receptor agonists. Romiplostim N01 was associated with favorable platelet recovery proportions and a manageable safety profile in patients with lung cancer and severe persistent CTIT. These findings suggest that Romiplostim N01 is a viable option for managing severe persistent CTIT, though further large-scale, multicenter studies are needed to validate its platelet recovery outcomes and safety across diverse patient populations.