Effectiveness of adjuvant carboplatin-based chemotherapy compared to cisplatin in non-small cell lung cancer

Abstract

Background

Cisplatin and vinorelbine given intravenously is a well-established adjuvant chemotherapy regimen after surgery for early non-small cell lung cancer. However, few validated alternatives exist when cisplatin is not indicated or tolerated. Carboplatin is frequently used in this setting. We evaluated the 5-year overall survival, progression-free survival and toxicity in patients treated for stage IB to IIIB resected non-small cell lung cancer receiving adjuvant carboplatin-based chemotherapy compared to cisplatin in association with vinorelbine.

Methods

Single-center retrospective study of patients having received adjuvant chemotherapy between January 2004 and December 2013 at the oncology clinic at Institut Universitaire de Cardiologie et de Pneumologie de Québec (Canada). Three sub-groups, cisplatin/vinorelbine, carboplatin/vinorelbine and the substitution of cisplatin/vinorelbine for carboplatin/vinorelbine (cisplatin/vinorelbine/carboplatin/vinorelbine), were studied during treatment.

Results

One hundred twenty-seven patients were included in this study. The median PFS was not significantly different, with 50.4 months for cisplatin/vinorelbine, 57.3 months for cisplatin/vinorelbine/carboplatin/vinorelbine and not yet achieved for the carboplatin/vinorelbine group (p = 0.80). Overall survival also did not differ significantly between the three groups. The 5-year overall survival rates were 66% in cisplatin/vinorelbine group, 55% in carboplatin/vinorelbine group and 70% in cisplatin/vinorelbine/carboplatin/vinorelbine group (p = 0, 95). No differences were noted between groups concerning high-grade hematologic toxicity.

Conclusions

Although the effectiveness and hematologic toxicity are comparable between cisplat in and carboplatin in the adjuvant treatment of resected non-small cell lung cancer, the results obtained corroborate the practice used at our oncology clinic. Nevertheless, more prospective studies would be needed to confirm these results.

Keywords

Adjuvant chemotherapy cisplatin carboplatin vinorelbine non-small cell lung cancer survival

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References

Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian cancer statistics 2013, Toronto, ON: Canadian Cancer Society, 2013.

American Cancer Society. Cancer facts & figures 2014, Atlanta: American Cancer Society, 2014.

Ardizzoni

Boni

Tiseo

et al.

Cisplatin- versus carboplatin-based chemotherapy in first-line treatment of advanced non-small-cell lung cancer: an individual patient data meta-analysis. J Nat Cancer Inst 2007; 99: 847–857.

Govindan

Page

Morgensztern

et al.

Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol 2006; 24: 4539–4544.

Kalemkerian

. Adjuvant therapy for non-small-cell lung cancer. Lancet 2010; 375: 1230–1231.

Winton

Livingston

Johnson

et al.

Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 2005; 352: 2589–2597.

Pignon

Tribodet

Scagliotti

et al.

Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE collaborative group. J Clin Oncol 2008; 26: 3552–3559.

Ettinger

Bepler

Bueno

et al.

Non-small cell lung cancer clinical practice guidelines in oncology. J Natl Compr Canc Netw 2006; 4: 548–582.

Pisters

Evans

Azzoli

et al.

Cancer Care Ontario and American Society of Clinical Oncology adjuvant chemotherapy and adjuvant radiation therapy for stages I-IIIA resectable non-small-cell lung cancer guideline. J Clin Oncol 2007; 25: 5506–5518.

10.

O'Dwyer

Stevenson

Johnson

. Clinical pharmacokinetics and administration of established platinum drugs. Drugs 2000; 59: 19–27.

11.

Hotta

Matsuo

Ueoka

et al.

Meta-analysis of randomized clinical trials comparing Cisplatin to Carboplatin in patients with advanced non-small-cell lung cancer. J Clin Oncol 2004; 22: 3852–3859.

12.

Jiang

Liang

Zhou

et al.

A meta-analysis of randomized controlled trials comparing carboplatin-based to cisplatin-based chemotherapy in advanced non-small cell lung cancer. Lung Cancer 2007; 57: 348–358.

13.

De Castria

Da Silva

Gois

et al.

Cisplatin versus carboplatin in combination with third-generation drugs for advanced non-small cell lung cancer. Cochr Database Syst Rev 2013; 8: Cd009256–Cd009256.

14.

Adjei

. Review of the comparative pharmacology and clinical activity of cisplatin and carboplatin. J Clin Oncol 1999; 17: 409–422.

15.

Klastersky

Sculier

Lacroix

et al.

A randomized study comparing cisplatin or carboplatin with etoposide in patients with advanced non-small-cell lung cancer. J Clin Oncol 1990; 8: 1556–1562.

16.

Ettinger

Wood

Akerley

et al.

Non-small cell lung cancer, version 1.2015. J Natl Compr Canc Netw 2014; 12: 1738–1761.

17.

Strauss

Herndon

Maddaus

2nd et al.

Adjuvant paclitaxel plus carboplatin compared with observation in stage IB non-small-cell lung cancer. J Clin Oncol 2008; 26: 5043–5051.

18.

Common terminology criteria for adverse events V4.0 (CTCAE), Cancer Therapy Evaluation Program, http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcae_4_with_lay_terms.pdf (2010, accessed on 15 April 2014).

19.

Chang

Sun

Lee

et al.

A retrospective comparison of adjuvant chemotherapeutic regimens for non-small cell lung cancer (NSCLC). Lung Cancer 2014; 84: 51–55.

20.

Thomas

Robinet

Gouva

et al.

Randomized multicentric phase II study of carboplatin/gemcitabine and cisplatin/vinorelbine in advanced non-small cell lung cancer. Lung Cancer 2006; 51: 105–114.

21.

Booton

Lorigan

Anderson

et al.

A phase III trial of docetaxel/carboplatin versus mitomycin C/ifosfamide/cisplatin (MIC) or mitomycin C/vinblastine/cisplatin (MVP) in patients with advanced non-small-cell lung cancer. Ann Oncol 2006; 17: 1111–1119.