{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:13:20Z","timestamp":1788786800054,"version":"build-2803163510"},"reference-count":34,"publisher":"American Society of Clinical Oncology (ASCO)","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Chemotherapy-induced thrombocytopenia (CIT) is a challenging and common complication of cytotoxic chemotherapy in patients with GI cancers. There is no widely available approved treatment. Avatrombopag is a potent, second-generation oral thrombopoietin receptor agonist promising for CIT management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We conducted a multicenter, randomized, double-blind, investigator-initiated US trial of avatrombopag or placebo (1:1) in GI cancer patients with persistent CIT (platelets \u226485 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L on day 1 of a chemotherapy cycle despite adequate time to recover from the prior cycle). The primary end point was successful correction of CIT and prevention of recurrence (defined as recovery of platelets to \u2265100 \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L, no chemotherapy dose modification\/delay, and prevention of CIT recurrence [platelets \u2265100 \u00d7 109\/L] at end of the on-study cycle).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The trial was closed to enrollment by the data and safety monitoring board at the planned interim analysis after meeting prespecified stopping criteria for efficacy. Sixteen of 23 patients (70% [95% CI, 47 to 87]) receiving avatrombopag achieved the primary end point versus 4\/24 patients (17% [95% CI, 5 to 37]) receiving placebo (\n                      <jats:italic toggle=\"yes\">Z<\/jats:italic>\n                      = 3.67,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). The median (IQR) platelet count at the end of the on-cycle treatment period was 157 (136-202) \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L with avatrombopag versus 72 (68-134) \u00d7 10\n                      <jats:sup>9<\/jats:sup>\n                      \/L with placebo. Adverse events (AEs) and serious AEs occurred in 78% and 17% of patients receiving avatrombopag and 46% and 0% of patients receiving placebo, respectively. No serious AEs were study drug-related. There were no treatment-related AEs leading to death or discontinuation of study drug.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In this randomized, placebo-controlled trial, avatrombopag was efficacious in the management of persistent CIT in patients with GI cancers. These findings are promising for a common, challenging oncologic complication that prevents delivery of full-dose, on-time, cancer-directed therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco-26-00568","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T19:59:15Z","timestamp":1783972755000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":1,"title":["Avatrombopag Versus Placebo for Persistent Chemotherapy-Induced Thrombocytopenia in GI Cancers: The Phase II ACT-GI Trial"],"prefix":"10.1200","clinical-trial-number":[{"clinical-trial-number":"nct05772546","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6175-1383","authenticated-orcid":false,"given":"Hanny","family":"Al-Samkari","sequence":"first","affiliation":[{"name":"Mass General Brigham Cancer Institute, Massachusetts General Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J.","family":"Shatzel","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Oregon Health and Science University, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhya R.","family":"Panch","sequence":"additional","affiliation":[{"name":"Fred Hutch Cancer Center, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0877-4030","authenticated-orcid":false,"given":"Julia H.","family":"Keating","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth P.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Mass General Brigham Cancer Institute, Massachusetts General Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin D.","family":"Weekes","sequence":"additional","affiliation":[{"name":"Mass General Brigham Cancer Institute, Massachusetts General Hospital, Boston, MA"},{"name":"Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6241-4896","authenticated-orcid":false,"given":"Adel","family":"Kardosh","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Oregon Health and Science University, Portland, OR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6207-9856","authenticated-orcid":false,"given":"Stacey A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Fred Hutch Cancer Center, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2345-1910","authenticated-orcid":false,"given":"Jonathan J.","family":"Cohen","sequence":"additional","affiliation":[{"name":"University of Miami Health System\/Sylvester Comprehensive Cancer Center, Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela G.","family":"Hodges","sequence":"additional","affiliation":[{"name":"Mass General Brigham Cancer Institute, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilton E.","family":"Dhaver","sequence":"additional","affiliation":[{"name":"Mass General Brigham Cancer Institute, Massachusetts General Hospital, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Strojny","sequence":"additional","affiliation":[{"name":"Mass General Brigham Cancer Institute, Massachusetts General Hospital, Boston, 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