Cisplatin superior to carboplatin for first-line treatment of non-small-cell lung cancer

Researchers have reported a higher response rate for cisplatin compared with carboplatin when used to treat non-small cell lung cancer (NSCLC) according to results presented in this month’s Journal of the National Cancer Institute.

Pooled data from nine clinical trials comparing cisplatin to carboplatin as first-line treatment of patients with stage IIIb-IV non-small-cell lung cancer were analysed. The author’s found a significantly higher objective response rate (ORR) with cisplatin versus carboplatin (30% versus 24%, respectively; P<.001). There was a trend towards increased survival in patients receiving cisplatin, compared with those patients receiving carboplatin. In addition, cisplatin was more effective in prolonging survival in cases treated with third-generation regimens and in those with non-squamous histology.

Author’s conclusions: ‘Our individual patient data meta-analysis suggests that cisplatin-based chemotherapy is slightly superior to carboplatin-based chemotherapy in terms of response rate and, in certain subgroups, in prolonging survival without being associated with an increase in severe toxic effects. Therefore, cisplatin-based third-generation regimens should remain the standard reference for the treatment of selected patients with advanced-stage NSCLC and of those with earlier-stage disease.

Cisplatin-based chemotherapy was associated with more severe nausea and vomiting and nephrotoxicity, wherease severe thrombocytopenia was more frequent during carboplatin-based chemotherapy.


Source: http://jnci.oxfordjournals.org/cgi/content/abstract/99/11/847