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Evidence summaries

Platinum-Based Chemotherapy Regimens for Small-Cell Lung Cancer

Platinum-based chemotherapy regimens appear not to provide significant benefit over non-platinum regimens for small cell lung cancer in terms of survival but appear to provide better complete tumour response rates. Level of evidence: "B"

The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding).

Summary

A Cochrane review [Abstract] 1 included 32 studies comparing platinum and non-platinum chemotherapy regimens in the treatment of small cell lung cancer (SCLC), with a total of 6 075 subjects. The duration of studies ranged from 12 to 72 months (median 32 months), and the median age of patients in the vast majority of studies was between 60 and 65 years of age. Co-intervention with radiotherapy occurred in approximately 72% of studies. Eighteen studies presented data on extensive-stage disease, 9 studies presented data on limited-stage disease, and 11 did not present data based on the disease stage. There was no statistically significant difference between treatment groups in terms of survival at 6 months, 12 months and 24 months. There was also no statistically significant difference in terms of overall tumour response. However, platinum-based treatment regimens did have a significantly higher rate of complete response. Platinum-based chemotherapy regimens had significantly higher rates of nausea and vomiting, and thrombocytopenia toxicity.

    References

    • Amarasena IU, Chatterjee S, Walters JA et al. Platinum versus non-platinum chemotherapy regimens for small cell lung cancer. Cochrane Database Syst Rev 2015;(8):CD006849. [PubMed]

Primary/Secondary Keywords