Carboplatin- or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: The COCIS meta-analysis of individual patient data

Antonio Rossi, Massimo Di Maio, Paolo Chiodini, Robin Michael Rudd, Hiroaki Okamoto, Dimosthenis Vasilios Skarlos, Martin Früh, Wendi Qian, Tomohide Tamura, Epaminondas Samantas, Taro Shibata, Francesco Perrone, Ciro Gallo, Cesare Gridelli, Olga Martelli, Siow Ming Lee

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Abstract

Purpose: Since treatment efficacy of cisplatin- or carboplatin-based chemotherapy in the first-line treatment of small-cell lung cancer (SCLC) remains contentious, a meta-analysis of individual patient data was performed to compare the two treatments. Patients and Methods: A systematic review identified randomized trials comparing cisplatin with carboplatin in the first-line treatment of SCLC. Individual patient data were obtained from coordinating centers of all eligible trials. The primary end point was overall survival (OS). All statistical analyses were stratified by trial. Secondary end points were progression-free survival (PFS), objective response rate (ORR), and treatment toxicity. OS and PFS curves were compared by using the log-rank test. ORR was compared by using the Mantel-Haenszel test. Results: Four eligible trials with 663 patients (328 assigned to cisplatin and 335 to carboplatin) were included in the analysis. Median OS was 9.6 months for cisplatin and 9.4 months for carboplatin (hazard ratio [HR], 1.08; 95% CI, 0.92 to 1.27; P = .37). There was no evidence of treatment difference between the cisplatin and carboplatin arms according to sex, stage, performance status, or age. Median PFS was 5.5 and 5.3 months for cisplatin and carboplatin, respectively (HR, 1.10; 95% CI, 0.94 to 1.29; P = .25). ORR was 67.1% and 66.0%, respectively (relative risk, 0.98; 95% CI, 0.84 to 1.16; P = .83). Toxicity profile was significantly different for each of the arms: hematologic toxicity was higher with carboplatin, and nonhematologic toxicity was higher with cisplatin. Conclusion: Our meta-analysis of individual patient data suggests no differences in efficacy between cisplatin and carboplatin in the first-line treatment of SCLC, but there are differences in the toxicity profile.

Original languageEnglish
Pages (from-to)1692-1698
Number of pages7
JournalJournal of Clinical Oncology
Volume30
Issue number14
DOIs
Publication statusPublished - May 10 2012

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Rossi, A., Di Maio, M., Chiodini, P., Rudd, R. M., Okamoto, H., Skarlos, D. V., Früh, M., Qian, W., Tamura, T., Samantas, E., Shibata, T., Perrone, F., Gallo, C., Gridelli, C., Martelli, O., & Lee, S. M. (2012). Carboplatin- or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: The COCIS meta-analysis of individual patient data. Journal of Clinical Oncology, 30(14), 1692-1698. https://doi.org/10.1200/JCO.2011.40.4905