Carboplatin versus cisplatin in combination with etoposide in the first-line treatment of small cell lung cancer: A pooled analysis

Extensive-stage small cell lung cancer (ES-SCLC) is an aggressive disease with poor survival, and platinum-etoposide chemotherapy is indicated as the mainstay of treatment. In this study, we compared the efficacy and safety between the cisplatin plus etoposide (EP) and carboplatin plus etoposide (EC) regimens.
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Carboplatin versus cisplatin in combination with etoposide in the first-line treatment of small cell lung cancer: A pooled analysisJiangetal. BMC Cancer (2021) 21:1308https://doi.org/10.1186/s12885-021-09034-6 RESEARCH Open AccessCarboplatin versuscisplatin incombinationwithetoposide inthefirst-line treatmentofsmall cell lung cancer: apooled analysisShiyuJiang1,6†, LilingHuang2†, HongnanZhen3, PeijieJin4, JingWang5,6*and ZhihuangHu1,6*  Abstract  Background:  Extensive-stage small cell lung cancer (ES-SCLC) is an aggressive disease with poor survival, and platinum-etoposide chemotherapy is indicated as the mainstay of treatment. In this study, we compared the efficacy and safety between the cisplatin plus etoposide (EP) and carboplatin plus etoposide (EC) regimens. Methods:  A total of 1305 patients with previously untreated ES-SCLC were included in this study. Data from five trials were collected from the public database Project Data Sphere. Survival analysis and adverse events (AEs) analysis were conducted. Results:  Of the 1305 patients, 800 received the EC regimen whereas 505 received the EP regimen as their front-line treatment. Overall, the median progression-free survival (PFS) and the median overall survival (OS) were 172 and 289 days, respectively. The EP and EC treatment groups did not have significantly different PFS or OS. After adjusting for age, sex, body mass index (BMI) and Eastern Cooperative Oncology Group (ECOG) performance status (PS), the EP regimen was independently associated with better PFS (hazard ratio [HR] = 0.76, 95% CI = 0.63–0.92, p = 0.0041) and OS (HR = 0.79, 95% CI = 0.64–0.97, p = 0.0220) among patients who were overweight and obese (BMI ≥ 25 kg/m2). In the safety analysis, patients who received the EC treatment experienced significantly more grade ≥ 3 AEs (n = 599, 74.9%) than those who received the EP treatment (n = 337, 66.7%; p = 0.002). Furthermore, the EC regimen was asso- ciated with a higher risk of grade 3–4 neutropaenia (p = 0.001), thrombocytopaenia (p  200,000 cases [1, 2]. Despite concurrent1 Department ofMedical Oncology, Fudan University Shanghai Cancer chemoradiation and the initial response to platinum-Center; Institute ofThoracic Oncology, Fudan University, 270 Dongan Rd,Shanghai200032, China based chemotherapy, the prognosis for this disease5 Department ofAnesthesiology, Fudan University Shanghai Cancer remains poor, with a median survival of 20–24 andCenter, Shanghai200032, ChinaFull list of author information is available at the end of the article © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creat​iveco​mmons.​org/​licen​ses/​by/4.​0/. The Creative Commons Public Domain Dedication waiver (http://​creat​iveco​ mmons.​org/​publi​cdoma​in/​zero/1.​0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Jiangetal. BMC Cancer (2021) 21:1308 Page 2 of 710–12 months for patients at the limited and extensive patients with previously untreated ES-SCLC from fivestages, respectively [3]. trials using data from the Project Data Sphere. In terms of systemic treatment for SCLC, most evi-dence indicates the superiority of platinum-basedregimens compared to non-platinum-based ones Patients andmethodsamong de novo patients with extensive-stage small Patientscell lung c ...