Comparing different chemotherapy combinations to improve treatment of extensive-stage small cell lung cancer

This study looked at a combination of irinotecan (Camptosar) and platinum-based drugs, for treating patients with extensive-stage small cell lung cancer. The authors concluded that this combination has the potential to improve the outcomes for these patients.  

Extensive stage small-cell lung cancer (ES-SCLC) is commonly treated with chemotherapy. The standard treatment involves a combination of etoposide (Etopopho) and a platinum-based chemotherapy drug (EP). Carboplatin (Paraplatin) and cisplatin (Platinol) are platinum-based drugs. There is inconclusive evidence to suggest that other combinations may be more effective. One other combination uses irinotecan and a platinum-based chemotherapy drug. It remains unclear if this combination can help patients with ES-SCLC.

This study analyzed data from 9 trials that compared irinotecan and platinum chemotherapy (IP) with the EP regimen. Overall, it included 2451 patients with ES-SCLC. 

The authors looked at overall survival (OS, time from beginning trial until death), progression-free survival (PFS, time from beginning trial until disease progression) and overall response rate (ORR, the percentage of patients with tumor size reduction). Treatment with IP was compared to treatment with EP. 

There was a 15% improvement in OS in patients treated with IP, compared to those treated with EP. There was a 12% improvement in PFS in patients treated with IP. The ORR was also 8% higher in patients treated with IP.

Patients treated with IP had a lower risk of hematological (blood-based) side effects such as anemia, low white blood cell count and thrombocytopenia (low platelet count). Patients treated with IP had an almost 8-fold higher risk of diarrhea compared to those treated with EP. 

The authors concluded that treatment with irinotecan and platinum-based drugs improved the outcomes for patients with ES-SCLC. 

The studies included in this trial had different chemotherapy doses, which could affect the results.