• Posted March 17, 2026

Drug Protects Against Chemo-Caused Bleeding, Trial Shows

An already approved drug can help protect cancer patients against excessive bleeding caused by chemotherapy, a new study says.

Chemotherapy-induced thrombocytopenia occurs when chemo destroys platelet-producing bone marrow cells, increasing a person’s risk of dangerous bleeding.

But the injectable drug romiplostim (Nplate) can effectively prevent chemo from causing thrombocytopenia, by boosting bone marrow cells’ ability to withstand the cancer treatment, researchers reported recently in The New England Journal of Medicine.

“This work has been nearly a decade in the making, and it is so important because there are no available approved medications for chemotherapy-induced thrombocytopenia, which drastically increases a patient’s risk of major or life-threatening bleeding,” said lead researcher Dr. Hanny Al-Samkari, a hematologist at Mass General Brigham Cancer Institute in Boston.

Up to now, cancer doctors have had to reduce or delay chemo to prevent life-threatening bleeding in these patients, he said.

“We know from other studies that this chemotherapy intensity reduction results in worsened outcomes of cancer treatment, including reduced overall survival and lower chance of cancer cure,” Al-Samkari said in a news release. “Therefore, we hope that romiplostim’s ability to allow administration of full-dose chemotherapy delivered on time will translate into longer survival for patients.”

Romiplostim is approved as a treatment for people with thrombocytopenia caused by immune system disorders, according to Drugs.com. 

The U.S. Food and Drug Administration approved the med in 2008, and no generic version is currently available.

To see if the drug also would help against chemo-related thrombocytopenia, researcher recruited 165 patients with advanced colon, gastroesophageal or pancreatic cancer. Two-thirds were randomly prescribed romiplostim, and the rest got a placebo.

Patients taking romiplostim had more than 10-fold lower odds of having to reduce their chemo dose due to thrombocytopenia, the study showed.

No chemotherapy dose modifications were made in 84% of patients on romiplostim, compared with 36% of those on a placebo, researchers found.

The most common side effects related to romiplostim were nausea and headache, but none were serious enough to discontinue either the drug or chemo, the study said.

More serious side effects occurred in 37% of patients on romiplostim and 22% of those on placebo. Researchers said this primarily reflected the side effects from chemo, and the fact that romiplostim patients could take higher doses of chemo.

More information

Harvard Medical School has more on thrombocytopenia.

SOURCE: Mass General Brigham, news release, March 12, 2025