Comparing the efficacy and risks of two first line chemotherapy treatments for small-cell lung cancer patients

This analysis investigated the differences in treatment efficacy and safety between cisplatin and carboplatin, two first line chemotherapeutic drugs used in the treatment of small-cell lung cancer (SCLC) patients.

First line treatment (the initial treatment of choice) of SCLC patients includes a platinum based chemotherapy. Platinum based drugs, such as cisplatin and carboplatin, bind to the DNA (the cells' genetic material) and damage it, causing the death of rapidly growing cells (such as cancer cells). Different cancers show different responses to different agents. However, to date, no conclusions have been reached concerning the best first line chemotherapeutic agent for the treatment of SCLC.

A meta-analysis (an analysis of data combined from several similar studies) was conducted, which included 4 trails and a total of 663 patients, and compared the outcome of SCLC patients treated with either cisplatin or carboplatin. Overall survival and progression free survival (PFS; the time between treatment and until the disease worsens or progresses) were examined to assess the efficacy of each treatment. The rate of adverse effects was also compared between treatments.

The analysis showed no significant differences between cisplatin and carboplatin treatment. PFS was 5.5 months for cisplatin treatment and 5.3 months for carboplatin treatment. Overall survival was 9.6 months for cisplatin treated patients, and 9.4 months for carboplatin treated patients. However, among patients at different age groups PFS analysis showed that cisplatin based treatment was more beneficial for younger patients (less than 70 years of age), while carboplatin treatment showed more benefit in older patients (70 years of age or more).

Both treatments showed a similar rate of adverse events (harmful side effects). Carboplatin therapy was associated mainly with suppressing the immune system by reducing the action of white blood cells and suppressing bone marrow activity. Anemia (low oxygen carrying capacity of the blood) and bleeding problems were also associated mainly with carboplatin therapy. Cisplatin agents showed a higher incidence of nausea, vomiting, kidney injury, and nerve damage.

This analysis concluded that there was no significant difference between cisplatin and carboplatin treatment in the case of small-cell lung cancer patients. Both efficacy and safety seemed to be similar between treatment groups.

Consult with your physician regarding the optimal chemotherapy agents available in the treatment of small-cell lung cancer.