Carboplatin and cisplatin are interchangeable in patients with limited-stage small-cell lung cancer (LS-SCLC) undergoing chemoradiation, a real-world study suggests.
After adjusting for confounders, researchers found no significant difference in overall survival (OS) or time to next treatment (TTNT) between patients who received cisplatin and those who received carboplatin.
These findings were published in Cancer Treatment and Research Communications.
Researchers studied 1172 patients with LS-SCLC from the Flatiron Health database who received chemoradiation during 2013-2019 and were followed through May 2020. A total of 600 patients received carboplatin, and 572 received cisplatin, each in combination with etoposide and thoracic radiation.
Patients who received cisplatin tended to be younger than those who received carboplatin (median age, 65.2 years and 69.1 years, respectively; P <.001). Patients who received cisplatin also had a shorter time from diagnosis to radiation (median, 36 days vs 42 days, P =.001) and less kidney disease (1.6% vs 4.5%, P =.006).
In an unadjusted analysis, the median OS was significantly longer in the cisplatin group than in the carboplatin group — 22.3 months and 19.2 months, respectively (hazard ratio [HR], 0.83; P =.017).
However, in an adjusted analysis, the difference in OS between the groups was no longer significant (HR, 0.93, P =.378).
There were no significant differences in TTNT. In an unadjusted analysis, the median TTNT was 12.8 months in the cisplatin group and 12.7 months in the carboplatin group (HR, 0.91; P =.224). In an adjusted analysis, the difference between the groups was still not significant (HR, 0.96; P =.570).
“When balancing on key clinical factors, we observed no statistical difference in OS or TTNT by platinum choice in real-world LS-SCLC patients treated with CRT [chemoradiation],” the researchers wrote. “Although observational, the results from this large data set are consistent with the hypothesis that either cisplatin or carboplatin is an appropriate therapy regardless of health status.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Sama S, Kerrigan K, Sinnott JA, et al. Real-world comparison of survival outcomes with cisplatin versus carboplatin in patients with limited-stage small-cell lung cancer. Cancer Treat Res Commun. Published online January 21, 2023. doi:https://doi.org/10.1016/j.ctarc.2023.100686