Romiplostim Prevents Major Chemo Side Effect in Trial

New medication helps cancer patients avoid chemotherapy dose reductions due to platelet loss.

Mar. 13, 2026 at 7:26am

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A global phase 3 clinical trial led by investigators at Mass General Brigham found that the medication romiplostim can effectively prevent chemotherapy from destroying platelet-producing bone marrow cells, a common complication known as chemotherapy-induced thrombocytopenia. Romiplostim boosts the bone marrow's ability to withstand the assault of chemotherapy, allowing patients to continue receiving full-dose chemotherapy without having to reduce their doses due to low platelet counts.

Why it matters

Chemotherapy-induced thrombocytopenia is a major challenge in cancer treatment, often forcing oncologists to reduce chemotherapy doses or delay treatment, which can worsen patient outcomes. This new treatment offers hope for maintaining full chemotherapy intensity and improving survival for patients with advanced colorectal, gastroesophageal, and pancreatic cancers.

The details

The phase 3 RECITE trial included 165 patients, with 109 receiving romiplostim and 56 receiving a placebo. Patients taking romiplostim had more than 10-fold lower odds of having to reduce their chemotherapy dose due to thrombocytopenia. No chemotherapy dose modifications were made in 84% of patients in the romiplostim group versus 36% in the placebo group. Adverse events were generally manageable, with 12% of romiplostim patients experiencing events related to the medication.

  • The phase 3 RECITE trial was conducted globally and led by investigators at Mass General Brigham.
  • The findings were published in the New England Journal of Medicine on March 13, 2026.

The players

Hanny Al-Samkari, MD

A classical hematologist at Mass General Brigham Cancer Institute and the Peggy S. Blitz Endowed Chair in Hematology/Oncology, and the lead author of the study.

Mass General Brigham

The academic medical center that led the global phase 3 clinical trial of romiplostim.

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What they’re saying

“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.”

— Hanny Al-Samkari, MD, Lead author and classical hematologist at Mass General Brigham Cancer Institute (New England Journal of Medicine)

What’s next

The researchers hope that romiplostim's ability to allow administration of full-dose chemotherapy delivered on time will translate into longer survival for patients with advanced colorectal, gastroesophageal, and pancreatic cancers.

The takeaway

This new treatment offers a promising solution to a major challenge in cancer care, potentially allowing patients to receive their full course of chemotherapy without dose reductions or delays due to low platelet counts, which could improve their chances of survival.