Outcomes of Small Cell Lung Cancer Patients Treated With Cisplatin-Etoposide Versus Carboplatin-Etoposide

Karam, Irene; Jiang, Shi Yuan; Khaira, Mandip; Lee, Christopher W.; Schellenberg, Devin

doi:10.1097/coc.0b013e31828aab2a

Cited by 30 publications

(29 citation statements)

References 9 publications

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“…Similarly, studies at population-level found no significant difference in survival between combinations based on carboplatin or cisplatin [17,18]. Karam and colleagues reported a median OS of 11 months for carboplatin plus etoposide and 10 months for cisplatin plus etoposide for patients with extensive-stage SCLC in British Columbia from 2004 to 2008 [17]. These survival times are comparable with the times observed in our cohort, the median OS for carboplatin plus etoposide was 10.2 months and 12.2 months for cisplatin plus etoposide, the response rate was 60% and 58%, respectively.…”

Section: Discussionmentioning

confidence: 98%

“…For those patients with a good performance status, a combination of cisplatin and etoposide is considered the gold standard [14]. In clinical practice, however, carboplatin is frequently used instead of cisplatin, especially in older patients [15][16][17]. Also in our cohort, combinations based on etoposide plus carboplatin were used more frequently than combinations based on etoposide plus cisplatin (51 vs. 36%) and patients receiving carboplatin were older (median age 68 vs. 63 years).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have suggested that combination regimen with either cisplatin or carboplatin are comparable regarding ORR, PFS, and OS in first-line therapy: A meta-analysis of four randomised trials concluded that both regimens were equally effective (median OS 9.6 months for cisplatin and 9.4 months for carboplatin, with an overall response rate of 67% and 66%, respectively) and differed only in their toxicity profiles [15]. Similarly, studies at population-level found no significant difference in survival between combinations based on carboplatin or cisplatin [17,18]. Karam and colleagues reported a median OS of 11 months for carboplatin plus etoposide and 10 months for cisplatin plus etoposide for patients with extensive-stage SCLC in British Columbia from 2004 to 2008 [17].…”

Section: Discussionmentioning

confidence: 99%

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Treatment and outcome of 432 patients with extensive-stage small cell lung cancer in first, second and third line – Results from the prospective German TLK cohort study

Steffens¹,

Elender

Hutzschenreuter

et al. 2019

Lung Cancer

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Despite intensive research, the therapeutic options in extensive-stage small cell lung cancer (SCLC) are still limited. Data from routine clinical practice, so-called "real-world data", are centrally important to assess and improve the standard of care. We present prospectively documented data on systemic first-, second-and third-line treatment, number of treatment lines and outcome parameters of patients treated by medical oncologists in Germany. Materials and methods: This is a descriptive analysis on 432 patients with extensive-stage SCLC enrolled at start of first-line therapy into the prospective German clinical cohort study TLK (Tumour Registry Lung Cancer). Patients were recruited by 87 sites between February 2010 and December 2013 and followed-up individually for 3 years. Results: The majority of patients (93%) received a first-line platinum-based combination therapy. Carboplatin plus etoposide was documented more frequently than cisplatin plus etoposide (46 vs. 35%); patients receiving carboplatin were older (68 vs. 63 years) and more often presented with poorer performance status (17 vs. 11% ECOG ≥ 2). Both regimens yielded similar response and survival rates. Median first-line overall survival (OS) was 10.2 months (95% confidence interval [CI] 8.6-12.3) for carboplatin plus etoposide and 12.2 months (95% CI 10.1-14.7) for cisplatin plus etoposide. Most patients (77%) would have been eligible for participation in a clinical trial. 50% of the patients received a second and 22% a third line of treatment. Median second-line OS was 5.8 months (95% CI 4.8-7.5), median third-line OS 5.7 months (95% CI 3.8-7.0). Conclusion: To our knowledge, this is the first study of prospectively documented patients with extensive-stage SCLC in routine clinical practice. We present treatment algorithms as well as outcome parameters for a large cohort in first-, second-and third-line treatment. The survival times and response rates reported in this routine setting correspond to the respective measures from large prospective trials.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Treatment and outcome of 432 patients with extensive-stage small cell lung cancer in first, second and third line – Results from the prospective German TLK cohort study

Steffens¹,

Elender

Hutzschenreuter

et al. 2019

Lung Cancer

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“…Similarly, on multivariate analysis, there was no significance in OS between cisplatin (9.6 months) and carboplatin (9.4 months) use (De Ruysscher et al, 2011). Karam's et al also found no significant differences between carboplatin and cisplatin in terms of median OS (23 versus 18 months, p=0.10), and loco-regional control at 1 year (81% versus 68%, p=0.97) (Karam et al, 2013).…”

Section: Discussionmentioning

confidence: 98%

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Bayman¹,

Etiz²,

Akçay³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: It is standard treatment to combine chemotherapy (CT) and thoracic radiotherapy (TRT) in treating patients with limited stage small cell lung cancer (LS-SCLC). However, optimal timing of TRT is unclear. We here evaluated the survival impact of early versus late TRT in patients with LS-SCLC. Materials and Methods: Follow-up was retrospectively analyzed for seventy consecutive LS-SCLC patients who had successfully completed chemo-TRT between January 2006 and January 2012. Patients received TRT after either 1 to 2 cycles of CT (early TRT) or after 3 to 6 cycles of CT (late TRT). Survival and response rates were evaluated using the Kaplan-Meier method and comparisons were made using the multivariate Cox regression test. Results: Median follow-up was 24 (5 to 57) months. Carboplatin+etoposide was the most frequent induction CT (59%). Median overall, disease free, and metastasis free survivals in all patients were 15 (5 to 57), 5 (0 to 48) and 11 (3 to 57) months respectively. Late TRT was superior to early TRT group in terms of response rate (p=0.05). 3 year overall survival (OS) rates in late versus early TRT groups were 31% versus 17%, respectively (p=0.03). Early TRT (p=0.03), and incomplete response to TRT (p=0.004) were negative predictors of OS. Significant positive prognostic factors for distant metastasis free survival were late TRT (p=0.03), and use of PCI (p=0.01). Use of carboplatin versus cisplatin for induction CT had no significant impact on OS (p=0.634), DFS (p=0.727), and MFS (p=0.309). Conclusions: Late TRT appeared to be superior to early TRT in LS-SCLC treatment in terms of complete response, OS and DMFS. Carboplatin or cisplatin can be combined with etoposide in the induction CT owing to similar survival outcomes.

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“…Four randomised control trials with 663 patients included in the meta-analysis, which showed a median OS of 9.6 and 9.4 months for cisplatin and carboplatin respectively with a hazard ratio of 1.08 (95% CI 0.92-1.27) [32]. Similarly a descriptive study comparing the OS and locoregional control rates of SCLC patients receiving cisplatin-etoposide or carboplatin-etoposide showed median OS of 23 months versus 18 months (p = 0.10) in limited stage, 10 months vs 11 months (p=0.24) in extensive stage disease [33]and an overall 12 month locoregional control rate of 81% versus 61%.…”

Section: Small-cell Lung Cancer (Sclc)mentioning

confidence: 99%

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Woodward

Coward

2016

Critical Reviews in Oncology/Hematology

255

135

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2 Highlights Platinum analogues, cisplatin and carboplatin, represent some of the most active cytotoxic agents in clinical oncology and are the backbone of most chemotherapeutic regimens  Despite relative similarities in mechanisms of action and activities, there are significant differences in both efficacy and toxicities for both platinum analogues in various malignancies  Carboplatin is a useful alternative in situations where cisplatin is contraindicated and this is not universally at the expense of efficacy  Platinum resistance, both de novo and acquired, is inevitable and understanding the mechanisms of resistance is essential in improving outcomes  Despite the burgeoning era of targeted therapies, the role of efficient DNA damaging agents such as platinum salts remains paramount especially in combination with these novel drugs.3 AbstractThe platinum analogues, cisplatin and carboplatin, are among the most widely used chemotherapeutic agents in oncology. Both agents have a broad spectrum of clinical activity in numerous malignancies including gynaecological cancers, germ cell tumours, head and neck cancer, thoracic cancers and bladder cancer. Although the final mechanism of inducing tumour cell apoptosis is similar for both compounds, cisplatin has been shown to be more effective in treating specific tumour types. Whilst more favourable toxicity profiles are often associated with carboplatin, this can frequently translate to inferior response in certain malignancies. This review succinctly collates the evidence for the preferential use of these platinum analogues in particular settings in addition to the long-standing dilemma surrounding the paucity of biomarkers predicting response to these agents.

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Outcomes of Small Cell Lung Cancer Patients Treated With Cisplatin-Etoposide Versus Carboplatin-Etoposide

Abstract: Despite the preferential use of EC in an older population, median OS and LRC rates were not significantly different for patients treated with EP for both LD and ED SCLC.

Cited by 30 publications

References 9 publications

Treatment and outcome of 432 patients with extensive-stage small cell lung cancer in first, second and third line – Results from the prospective German TLK cohort study

Treatment and outcome of 432 patients with extensive-stage small cell lung cancer in first, second and third line – Results from the prospective German TLK cohort study

Timing of Thoracic Radiotherapy in Limited Stage Small Cell Lung Cancer: Results of Early Versus Late Irradiation from a Single Institution in Turkey

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

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