please allow either skipping the choosing item phase or a way to trash one of the given items, I find myself with bad options a lot of times when I choose to pick items
As items give +5 when i throw them, just add this as a fourth option. is a bit hard to find space in the UI but I am sure you could do it. And this removes the by far biggest annoyance for me.
Besides that:
If you can add 20 levels of progressively increasing challenge & some more items that can be unlocked through gameplay (exactly slay the spire core progression basically),