Abstract 229P
Background
Thrombocytopenia is common in patients with hepatocellular carcinoma (HCC) who had received targeted therapy and immunotherapy. Avatrombopag is a novel oral thrombopoietin receptor to treat thrombocytopenia. This study aims to investigate the efficacy and safety of avatrombopag in the treatment of thrombocytopenia induced by targeted therapy and immunotherapy in HCC.
Methods
This multicenter, prospective controlled study included HCC patients with thrombocytopenia (platelet count＜75×10ˆ9/L) secondary to targeted therapy and immunotherapy between April 2021and May 2023, patients received avatrombopag (60mg daily, 20 days), or traditional therapy including 1) IL-11 subcutaneous injection once a day for 7-14 days; 2) Leucogen Tablets (60mg/day, 20days); 3) Other. Patients were followed up on the 3rd, 7th, 14th, and 20th day in the treatment period. The primary endpoint was the proportion of patients reached a platelet count ≥75×10ˆ9/L at least once within 20 days.
Results
A total of 21 patients including 11 in the avatrombopag group and 10 in the control group were collected. The proportion of patients who had reached the primary endpoint ( platelet count ≥75×10ˆ9/L at least once) in the avatrombopag group was significantly higher than that in the control group, 91% (10/11) vs 20% (2/10), p=0.0019. In the avatrombopag group, 91%, 64%, and 36% of the patients achieved platelet count ≥75×10ˆ9/L at least 1, 2, and 3 times respectively during the treatment. Meanwhile, the average days required for patients reached platelet count ≥75×10ˆ9/L after receiving avatrombopag was 11±5.5 days, while that for the only 2 patients in the control group were 3 days. The proportion of patients who reached a platelet count ≥100×10ˆ9/L during the treatment period in the avatrombopag group were higher, though not significant (36% vs 10%, p=0.318). There was no serious adverse event occurred in both groups.
Conclusions
Compared with the control group, patients received avatrombopag treatment achieved favorable platelet recovery, which is continuously effective and safe, proving that avatrombopag is reliable and tolerable for the treatment of thrombocytopenia induced by targeted therapy and immunotherapy in HCC.
Clinical trial identification
ChiCTR2200059852.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.