Efficacy of Cisplatin Etoposide and Carboplatin Paclitaxel for NSCLC

For patients being treated for stage 3 unresectable non-small cell lung cancer (NSCLC), cisplatin-etoposide or carboplatin-paclitaxel demonstrate comparable efficacy when used concurrently with radiotherapy, according to a study published in JAMA Oncology.¹

Researchers conducted a systematic review of published clinical trial data to compare patient outcomes and toxicity between the 2 treatment regimens. They used software to create random and fixed effect models to perform a systematic analysis on survival, response rate, and toxic effects.

The study included 3090 patients from 31 studies who had undergone treatment with cisplatin-etoposide and 3728 patients from 48 studies who were treated with carboplatin-paclitaxel.

The response rates were not significantly different between the 2 treatment groups, with a 58% response rate with cisplatin-etoposide and 56% response rate with carboplatin-paclitaxel.

Median progression-free survival was 12 months for cisplatin-etoposide and 9.3 months for carboplatin-paclitaxel; overall survival was 19.6 months for cisplatin-etoposide and 18.4 months for carboplatin-paclitaxel. The 3-year survival rate was 31% for cisplatin-etoposide and 25% for carboplatin-paclitaxel.

Treatment with carboplatin-paclitaxel was, however, “associated with higher grade 3 to 4 hematological toxic effects compared with carboplatin-paclitaxel.” The rate of grade 3 to 4 pneumonitis and esophagitis was similar between the 2 groups.

Reference

1. Steuer CE, Behera M, Ernani V, et al. Comparison of concurrent use of thoracic radiation with either carboplatin-paclitaxel or cisplatin-etoposide for patients with stage III non-small-cell lung cancer: a systematic review. JAMA Oncol. 2016 Dec 15. doi: 10.1001/jamaoncol.2016.4280 [Epub ahead of print]