The use of romiplostim (Nplate) reduced treatment modifications due to chemotherapy-induced thrombocytopenia (CIT) in patients with gastrointestinal cancer.[1] A randomized phase III study enrolled 165 patients, of whom 84% in the romiplostim group achieved the goal.[1] Romiplostim significantly reduced chemotherapy delays and dose reductions caused by thrombocytopenia.[1][2] In a phase II trial, 85% of treated patients achieved platelet count improvement, allowing continuation of chemotherapy with a low incidence of recurrent CIT in the first two cycles.[2] Of the 60 patients in this study, 75% achieved platelet recovery within 3 weeks, and 44 of them continued weekly romiplostim therapy.[2] In long-term treatment (≥1 year) in 21 patients, romiplostim prevented a reduction in chemotherapy intensity; 70% had no CIT episodes, 4 patients had one delay and 2 dose reductions.[2] The study showed no overt adverse effects of romiplostim, although some patients experienced transient increases in platelets above 400 × 10^9/L, leading to dose adjustments.[1] Romiplostim is safe in solid tumors with chemotherapy-induced thrombocytopenia and allows timely full-dose chemotherapy.[1]