Efficacy and Safety of Eltrombopag 25 Mg for the Management of Chemotherapy-Induced Thrombocytopenia in Patients with Solid Tumours: A Retrospective Comparative Study

Background: Chemotherapy-induced thrombocytopenia (CIT) can compromise chemotherapy delivery in patients with solid tumours. This study evaluated the efficacy and safety of eltrombopag 25 mg compared with standard supportive care. Methods: This retrospective comparative analysis involved 200 adult patients suffering from solid tumours and experiencing CIT where 100 patients received eltrombopag 25 mg while the other 100 were under conventional supportive treatment. The outcomes of platelet recovery, platelet kinetics, changes in chemotherapy regimen, transfusions, bleeding, thromboembolic events, hepatotoxicity and adverse events were analysed using multivariable logistic regression. Results: There was adequate platelet recovery for administration of planned chemotherapy in 64.0% patients in eltrombopag group compared to 33.0% patients in control arm (OR 3.61, 95% CI 2.01-6.47; p<0.001). The eltrombopag was associated with increased platelet nadir, increased platelet count on day 7 and 14 and reduced time to recovery (9.1±2.8 versus 13.0±3.7 days; p<0.001). The incidence of chemotherapy delay and dose reduction was less common in eltrombopag group (20.0% versus 38.0%, p=0.005; 18.0% versus 36.0%, p=0.004, respectively). Conclusions: Low-dose eltrombopag 25 mg was associated with improved platelet recovery and fewer chemotherapy modifications without a statistically significant increase in adverse outcomes. Prospective randomized studies are warranted to confirm efficacy, define optimal treatment strategies and establish safety.