The results of a study recently published in the Journal of Clinical Oncology indicate that combination chemotherapy with cisplatin yields a significant survival benefit for patients with non-small cell lung cancer compared to combination chemotherapy with carboplatin.
Lung cancer is the leading cause of cancer-related deaths in the United States and Europe. The most common type of lung cancer, non-small cell lung cancer (NSCLC), is a malignancy that arises from the tissues of the lung. Under most circumstances, NSCLC is not curable. Current treatments include surgery, chemotherapy and radiation. Chemotherapy with a combination of platinum-based drugs and an additional type of chemotherapy drug is frequently used to treat NSCLC. Cisplatin and carboplatin are both platinum-based drugs that are active against lung cancer.
The current study reviewed 8 previous trials that included a total of 2,948 patients. Of the eight studies, five trials evaluated drug regimens containing platinum-based chemotherapy plus an additional chemotherapy drug. Results indicate that cisplatin-based chemotherapy regimens produced higher response rates than carboplatin-based regimens, but not a survival advantage. Further analysis of subgroups revealed that when the same second chemotherapy drug was used, cisplatin combination chemotherapy produced an 11% longer survival period than carboplatin combination chemotherapy. Although there was no significant difference in treatment-related mortality, patients who received cisplatin chemotherapy frequently experienced nausea and vomiting, while patients who received carboplatin experienced a drop in blood cell counts.
Researchers concluded that combination chemotherapy consisting of cisplatin and an additional chemotherapy agent produced a significant survival advantage, when compared to carboplatin combination chemotherapy. Although the study had some limitations, it raises important questions that will need to be addressed in future studies. Patients diagnosed with NSCLC are encouraged to speak to their physician regarding treatment options.
Reference: Hotta K, Matsuo K, Ueoka H, et al. Meta-analysis of randomized clinical trials comparing cisplatin to carboplatin in patients with advanced non-small cell lung cancer. Journal of Clinical Oncology. 2004; 22: 3852-3859.
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