In Stage 3 NSCLC, Cisplatin Plus Etoposide vs. Carboplatin Plus Paclitaxel Show Similar Survival

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According to a new study published in the Journal of Clinical Oncology, etoposide plus cisplatin results in a similar overall survival as carboplatin plus paclitaxel for the treatment of stage 3 non-small cell lung cancer (NSCLC) in a Veterans Health Administration population, but etoposide plus cisplatin was associated with increased morbidity.

For the study, researchers identified 1,842 patients with stage 3 NSCLC who were treated with either etoposide-cisplatin or carboplatin-paclitaxel with concurrent radiation between 2001 and 2010.

Various analyses demonstrated that treatment with etoposide-cisplatin did not result in a longer duration of overall survival compared with treatment with carboplatin-paclitaxel. A Cox proportional hazards model found a hazard ratio of 0.97 (95% CI: 0.85 - 1.10), a propensity score matched cohort determined a hazard ratio of 1.07 (95% CI: 0.91 - 1.24), and a propensity score adjusted model found a hazard ratio of 0.97 (95% CI: 0.85 - 1.10).

In addition, patients treated with etoposide-cisplatin had more hospitalizations (P < 0.001), outpatient visits (P < 0.001), infections (P = 0.0022, kidney injury (P < 0.001), and mucositis/espophagitis (P = 0.0246). 

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Etoposide plus cisplatin results in a similar overall survival as carboplatin plus paclitaxel for NSCLC.
The authors compare the outcome of patents treated within the Veterans Health Administration with either etoposide-cisplatin (EP) or carboplatin-paclitaxel (CP). After accounting for prognostic variables, patients treated with EP versus CP had similar overall survival, but EP was associated with increased morbidity.
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