According to a combined analysis of nine clinical trials, cisplatin produces slightly better response rates than carboplatin in the initial treatment of advanced non–small cell lung cancer. These results were published in the Journal of the National Cancer Institute.
Cancers of the lung are classified by how they appear under a microscope. While there are more than a dozen different kinds of lung cancer, the two main types of lung cancer are non–small cell and small cell, which together account for over 90% of all lung cancers. Non–small cell lung cancer (NSCLC) accounts for approximately 75% of these cancers and consists of squamous cell, adenocarcinoma, and large cell types.
Advanced NSCLC refers to cancer that has spread from the lung to distant sites in the body. Because overall long-term survival for patients with advanced NSCLC is suboptimal, researchers continue to evaluate novel therapeutic approaches for the treatment of this disease.
Cisplatin and carboplatin are platinum-based chemotherapy drugs that have been used in the treatment of NSCLC. Carboplatin has generally been reported to produce fewer serious side effects than cisplatin, but there has been some uncertainty about the relative efficacy of the two drugs.
To compare chemotherapy regimens that contain cisplatin to chemotherapy regimens that contain carboplatin in the first-line treatment of advanced NSCLC, researchers combined information from nine clinical trials. These trials enrolled a total of 2,968 patients.
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- Response rate was slightly better among patients treated with cisplatin than among patients treated with carboplatin. Thirty percent of patients treated with cisplatin experienced a partial or complete disappearance of detectable cancer compared with 24% of patients treated with carboplatin.
- Overall, there was no significant difference in survival between those treated with cisplatin and those treated with carboplatin. Cisplatin did improve survival in the following two subsets of patients, however: those with non-squamous NSCLC and those who were treated with newer chemotherapy regimens.
- Cisplatin-based chemotherapy resulted in more severe nausea and vomiting and kidney problems. Carboplatin-based chemotherapy resulted in a higher risk of severe thrombocytopenia (low platelet levels).
These results suggest that cisplatin produces slightly better response rates than carboplatin among patients with advanced NSCLC, and may also improve survival in certain subsets of patients.
Reference: Ardizzoni A, Boni L, Tiseo M et al. Cisplatin- versus carboplatin-based chemotherapy in first-line treatment of advanced non-small-cell lung cancer: an individual patient data meta-analysis. Journal of the National Cancer Institute. 2007;99:847-57.
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