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Persistent Isolated Chemotherapy-Induced ThrombocytopeniaPhase 2N01-A-PICIT-GINCT07586813

Romiplostim N01 Plus ATRA for Persistent Isolated Chemotherapy-Induced Thrombocytopenia After Complete Remission of Gastrointestinal Solid Tumors

A Phase 2 study testing Romiplostim N01 and All-trans retinoic acid in people with Persistent Isolated Chemotherapy-Induced Thrombocytopenia and Chemotherapy-Induced Thrombocytopenia, run by Peking University People's Hospital at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a prospective, randomized, open-label, active-controlled study to evaluate the efficacy and safety of Romiplostim N01 plus all-trans retinoic acid (ATRA) compared with Romiplostim N01 alone in adults with persistent isolated chemotherapy-induced thrombocytopenia (PICIT) after complete remission of… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Romiplostim N01 and All-trans retinoic acid
Could I receive a placebo?
No, everyone receives an active treatment
How many people
220 participants
Where
1 siteChina
Study dates
22 Dec 2025to 31 Dec 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 years or older.
  • Prior diagnosis of a gastrointestinal/digestive system solid tumor, including but not limited to gastrointestinal tract, pancreatic, or colorectal cancer.
  • Complete remission of the underlying tumor after chemotherapy or antitumor treatment, with tumor-related treatment discontinued for at least 12 weeks before enrollment, no evidence of recurrence or progression by specialist assessment, and no current need for additional tumor-directed therapy.
  • Persistent isolated chemotherapy-induced thrombocytopenia, defined as platelet count <30 x 10^9/L on two peripheral blood tests at least 7 days apart; or platelet count slightly higher than 30 x 10^9/L with dependence on platelet transfusion to maintain a safe platelet level.
  • Thrombocytopenia has persisted since the last chemotherapy treatment without a clear trend of spontaneous recovery.
  • Red blood cell count and neutrophil count are generally preserved, without clinically significant anemia or neutropenia.
Show all 13Show fewer
  • Bone marrow assessment performed within 1 year after tumor diagnosis and chemotherapy shows no tumor cell infiltration; megakaryocyte count is normal or increased, with or without maturation impairment.
  • No hepatosplenomegaly, portal hypertension, or other evidence suggesting abnormal platelet redistribution as the main cause of thrombocytopenia.
  • Prior treatment with at least one thrombopoietin receptor agonist or recombinant human thrombopoietin for PICIT without response, defined as failure of platelet count to rise to a safe level or to at least 2 times baseline after at least 2 weeks of standard-dose treatment.
  • No prior use of Romiplostim N01.
  • Other platelet-raising medications have been discontinued before enrollment. No washout period is required for prior thrombopoietin receptor agonists; other investigational drugs or off-label treatments must be discontinued for at least 1 month before enrollment.
  • Ability to understand and sign the informed consent form and willingness to comply with study visits and procedures.
  • Women of childbearing potential must have a negative pregnancy test before enrollment and agree to use effective contraception during study treatment.

Who cannot join

  • Other hematologic diseases that may affect hematopoiesis or cause thrombocytopenia, including but not limited to aplastic anemia, myelodysplastic syndrome, leukemia or other hematologic malignancies, or a clear history of primary immune thrombocytopenia.
  • Active recurrence or progression of the underlying tumor, or evidence of bone marrow metastasis or tumor cell infiltration on bone marrow examination.
  • Uncontrolled chronic viral infection, including hepatitis B, hepatitis C, or HIV infection, or active severe infection at screening or within 4 weeks before screening.
  • Severe cardiac, hepatic, renal, or other organ dysfunction, or any serious organic disease that would make the participant unable to tolerate study treatment.
  • Pregnancy or breastfeeding.
  • Known severe hypersensitivity to Romiplostim, Romiplostim N01, ATRA, or any component of the study drugs.
  • Prior Romiplostim treatment associated with severe adverse reactions or lack of efficacy.
  • Poor compliance, inability to complete treatment or follow-up, psychiatric or psychological condition that prevents understanding of the study procedures, or any other condition that, in the investigator's judgment, may increase study risk or interfere with interpretation of study results.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Xiaohui Zhang, MD contact

+8610-8832-4672

zhangxh@bjmu.edu.cn

Kexin Shen, MD contact

+8617710635036

keceyshen@gmail.com

China1 site, 1 recruiting
  • Peking University People's Hospital

    Beijing, 100044

    Xiaohui Zhang, MD, +8610-8832-4672, zhangxh@bjmu.edu.cn

    Kexin Shen, MD, +8617710635036, keceyshen@gmail.com

    Recruiting

Other trials in China

About this study

Official title: A Prospective, Randomized, Open-Label, Controlled Study of Romiplostim N01 Combined With All-Trans Retinoic Acid Versus Romiplostim N01 Alone for Persistent Isolated Chemotherapy-Induced Thrombocytopenia in Patients With Complete Remission of Gastrointestinal Solid Tumors

This is a prospective, randomized, open-label, active-controlled study to evaluate the efficacy and safety of Romiplostim N01 plus all-trans retinoic acid (ATRA) compared with Romiplostim N01 alone in adults with persistent isolated chemotherapy-induced thrombocytopenia (PICIT) after complete remission of gastrointestinal/digestive system solid tumors, including but not limited to gastrointestinal tract, pancreatic, and colorectal cancers.

Eligible participants will be randomized in a 1:1 ratio to receive Romiplostim N01 plus oral ATRA or Romiplostim N01 alone for 12 weeks, with follow-up through Week 24. The primary outcome is the overall platelet response rate at Week 12, defined as platelet count >50 x 10^9/L in at least 2 of the last 3 scheduled platelet assessments up to Week 12. Secondary outcomes include sustained response during Weeks 13 to 24, complete and partial response rates, duration of response, time to response, platelet count changes, platelet transfusion requirements, bleeding events, and safety.

Read the detailed description

Chemotherapy-induced thrombocytopenia is a clinically important complication of anticancer treatment. In some patients, thrombocytopenia persists after completion of chemotherapy despite complete remission of the underlying tumor. Persistent isolated chemotherapy-induced thrombocytopenia (PICIT) is characterized by prolonged thrombocytopenia with relatively preserved red blood cell and neutrophil counts, after exclusion of other causes of thrombocytopenia.

This study focuses on adult patients with PICIT after complete remission of gastrointestinal/digestive system solid tumors, including but not limited to gastrointestinal tract, pancreatic, and colorectal cancers. Romiplostim N01 is a thrombopoietin receptor agonist intended to stimulate megakaryocyte proliferation and platelet production. All-trans retinoic acid (ATRA) may provide additional hematopoietic and immunomodulatory effects. The study will compare Romiplostim N01 plus ATRA with Romiplostim N01 alone.

Eligible participants will be centrally randomized in a 1:1 ratio to one of two treatment arms. Participants in the experimental arm will receive Romiplostim N01 by subcutaneous injection once weekly plus oral ATRA twice daily for 12 weeks. Participants in the active comparator arm will receive Romiplostim N01 alone once weekly for 12 weeks. Romiplostim N01 dose adjustment will be based on platelet count according to the protocol. Supportive care and rescue treatment, including platelet transfusion for severe bleeding or clinically indicated thrombocytopenia, are permitted.

Participants will be followed weekly during Weeks 1 to 12 and every 2 weeks during Weeks 13 to 24. The primary endpoint is overall response rate at Week 12. Secondary endpoints include sustained response rate during Weeks 13 to 24, complete response rate, partial response rate, duration of response, time to response, platelet count changes, platelet transfusion requirements, bleeding events, and adverse events. Safety will be assessed by monitoring adverse events and serious adverse events, including ATRA-related toxicities and thrombopoietin receptor agonist-associated risks such as thromboembolic events.

Being tested
Romiplostim N01, All-trans retinoic acid
Keywords
PICIT, Persistent isolated chemotherapy-induced thrombocytopenia, CIT, Chemotherapy-induced thrombocytopenia, Romiplostim N01, ATRA, All-trans retinoic acid, Tretinoin, Thrombopoietin receptor agonist, Gastrointestinal solid tumor, Digestive system cancer, Pancreatic cancer, Colorectal cancer, Complete remission, Platelet response, Thrombocytopenia
Medical subject headings
Gastrointestinal Neoplasms, Pancreatic Neoplasms, Colorectal Neoplasms, Digestive System Neoplasms, Pathologic Complete Response, Thrombocytopenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Romiplostim N01Drug

    Also called N01, TPO receptor agonist, Thrombopoietin receptor agonist

    Romiplostim N01 will be administered by subcutaneous injection at an initial dose of 4 mcg/kg once weekly for 12 weeks. The dose may be adjusted according to platelet count: increase by 2 mcg/kg if platelet count is <50 x 10^9/L, with a maximum dose of 10 mcg/kg; maintain the current dose if platelet count is >=50 to <=200 x 10^9/L; reduce by 1 mcg/kg if platelet count is >200 to <=400 x 10^9/L; and withhold dosing if platelet count is >400 x 10^9/L, then restart at a lower dose after platelet count decreases to approximately 200 x 10^9/L.

  • All-trans retinoic acidDrug

    Also called ATRA, Tretinoin

    All-trans retinoic acid (ATRA) will be administered orally at 10 mg twice daily for 12 weeks. Dose interruption, reduction, or discontinuation may be performed for intolerable toxicity or clinically significant adverse events according to the protocol.

Study groups in NCT07586813
Study groupRoleWhat they receive
Romiplostim N01 Plus ATRAExperimentalParticipants randomized to this arm will receive Romiplostim N01 by subcutaneous injection once weekly for 12 weeks, with protocol-defined dose adjustment based on platelet count, plus oral all-trans retinoic acid (ATRA) 10 mg twice daily for 12 weeks. Supportive care and rescue treatment, including platelet transfusion when clinically indicated, are permitted according to the protocol.
Receives: Drug: Romiplostim N01; Drug: All-trans retinoic acid
Romiplostim N01 AloneActive comparatorParticipants randomized to this arm will receive Romiplostim N01 by subcutaneous injection once weekly for 12 weeks, with protocol-defined dose adjustment based on platelet count. Supportive care and rescue treatment, including platelet transfusion when clinically indicated, are permitted according to the protocol. Participants in this arm will not receive ATRA.
Receives: Drug: Romiplostim N01

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Platelet Response Rate at Week 12

    Percentage of participants with platelet count >50 x 10^9/L in at least 2 of the last 3 scheduled platelet assessments up to Week 12. Platelet transfusion or other rescue/supportive treatment will not be counted as a platelet response.

    Measured: From randomization to Week 12

Secondary outcomes (10)
  1. Sustained Platelet Response Rate During Weeks 13 to 24

    Percentage of participants with platelet count >50 x 10^9/L in at least 2 of the last 3 scheduled platelet assessments during Weeks 13 to 24 and without rescue therapy during this period.

    Measured: Weeks 13 through 24

  2. Complete Response Rate

    Percentage of participants with platelet count >=100 x 10^9/L and no bleeding for at least 2 consecutive weeks.

    Measured: Up to Week 24

  3. Partial Response Rate

    Percentage of participants with platelet count >=30 x 10^9/L and at least 2 times the baseline platelet count, with no bleeding.

    Measured: Up to Week 24

  4. Duration of Response

    Among responders, time from first achievement of platelet response to platelet count <30 x 10^9/L or the end of study follow-up.

    Measured: From first documented response to Week 24

  5. Time to Response

    Time from treatment start to the first platelet count >=30 x 10^9/L.

    Measured: From treatment start to Week 24

  6. Change in Platelet Count Over Time

    Change in peripheral blood platelet count from baseline at scheduled study visits.

    Measured: Baseline; weekly during Weeks 1 to 12; every 2 weeks during Weeks 13 to 24

  7. Platelet Transfusion Requirement

    Frequency and total amount of platelet transfusions during treatment and follow-up.

    Measured: From treatment start to Week 24

  8. Incidence of Bleeding Events

    Percentage of participants with any bleeding event and severity of bleeding events recorded during the study.

    Measured: From treatment start to Week 24

  9. Incidence of Adverse Events and Serious Adverse Events

    Adverse events and serious adverse events will be recorded and graded according to CTCAE version 5.0 and summarized by treatment arm.

    Measured: From first dose to Week 24

  10. Incidence of Thromboembolic Events

    Percentage of participants with confirmed thromboembolic events during treatment and follow-up.

    Measured: From first dose to Week 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 May 2026
  2. Study start22 Dec 2025
  3. Primary completion31 Oct 2027 (estimated)
  4. Study completion31 Dec 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Eligible adult participants with persistent isolated chemotherapy-induced thrombocytopenia after complete remission of gastrointestinal/digestive system solid tumors will be randomized in a 1:1 ratio to receive either Romiplostim N01 plus ATRA or Romiplostim N01 alone. Treatment will continue for 12 weeks, followed by observation through Week 24.
Masking
None (open label)
Enrolment
220 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07586813
Sponsor's protocol ID
2025PHD035-001-GI
Acronym
N01-A-PICIT-GI
Status last verified
May 2026
First submitted
7 May 2026
Last updated
14 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: The plan for sharing de-identified individual participant data has not yet been finalized. Any future data sharing will require approval by the sponsor and institutional ethics committee, compliance with the informed consent form and applicable privacy regulations, and execution of an appropriate data use agreement. No identifiable participant information will be shared.

Publications

  • Gao A, Zhang L, Zhong D. Chemotherapy-induced thrombocytopenia: literature review. Discov Oncol. 2023 Jan 25;14(1):10. doi: 10.1007/s12672-023-00616-3.

    PubMed 36695938
  • Yang J, Zhao L, Wang W, Wu Y. All-trans retinoic acid added to treatment of primary immune thrombocytopenia: a systematic review and meta-analysis. Ann Hematol. 2023 Jul;102(7):1695-1704. doi: 10.1007/s00277-023-05263-w. Epub 2023 May 11.

    PubMed 37166528
  • Vianelli N, Auteri G, Buccisano F, Carrai V, Baldacci E, Clissa C, Bartoletti D, Giuffrida G, Magro D, Rivolti E, Esposito D, Podda GM, Palandri F. Refractory primary immune thrombocytopenia (ITP): current clinical challenges and therapeutic perspectives. Ann Hematol. 2022 May;101(5):963-978. doi: 10.1007/s00277-022-04786-y. Epub 2022 Feb 24.

    PubMed 35201417
  • Soff GA, Al-Samkari H, Leader A, Eisen M, Saad H. Romiplostim in chemotherapy-induced thrombocytopenia: A review of the literature. Cancer Med. 2024 Aug;13(15):e7429. doi: 10.1002/cam4.7429.

    PubMed 39135303
  • Kuter DJ. Treatment of chemotherapy-induced thrombocytopenia in patients with non-hematologic malignancies. Haematologica. 2022 Jun 1;107(6):1243-1263. doi: 10.3324/haematol.2021.279512.

    PubMed 35642485

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Romiplostim N01 and All-trans retinoic acid in people with Persistent Isolated Chemotherapy-Induced Thrombocytopenia and Chemotherapy-Induced Thrombocytopenia, run by Peking University People's Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 14 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Xiaohui Zhang, MD (+8610-8832-4672, zhangxh@bjmu.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Platelet Response Rate at Week 12 (time frame: From randomization to Week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07586813, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 May 2026.

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