Cisplatin Superior to Carboplatin

[RandyW]

Cisplatin Superior to Carboplatin for Treating Curable Lung Cancer

NEW YORK JUN 05, 2007 (Reuters Health) - Cisplatin provides a higher response rate compared with carboplatin when used to treat non-small cell lung cancer (NSCLC), particularly for earlier stage disease and for patients with advanced disease but good prognosis, according to investigators in Europe and the US.

Dr. Andrea Ardizzoni, from University Hospital in Parma, Italy, and associates conducted a meta-analysis of individual patient data from randomized controlled clinical trials that compared treatment regimens containing either cisplatin or carboplatin.

They identified nine eligible trials, for which the respective electronic databases were obtained from principal investigators. They limited their analysis to data from 2968 patients with stage IIIb-IV NSCLC, of whom 1489 were randomly assigned to treatment that included cisplatin and 1479 to treatment including carboplatin.

The odds ratio for no objective response was 1.37 for carboplatin versus cisplatin (p = 0.001), the authors report in the Journal of the National Cancer Institute for June 6.

Cisplatin was more effective in prolonging survival in cases treated with third-generation regimens (hazard ratio of mortality with carboplatin relative to cisplatin = 1.11) and in those with nonsquamous histology (HR = 1.12).

Dr. Ardizzoni's team notes that "the superiority of cisplatin over carboplatin was not achieved at the cost of a statistically significant increase in the incidence of severe side effects." Cisplatin was associated with more cases of renal toxicity and nausea and vomiting, while carboplatin was associated with more cases of severe thrombocytopenia.

Based on their findings, Dr. Ardizzoni and associates conclude that, "cisplatin should remain the reference platinum agent for treatment of NSCLC, at least in advanced disease patients with good prognosis and in those with earlier stage disease."

Editorialists at Memorial Sloan-Kettering Cancer Center in New York, led by Dr. Christopher G. Azzoli, affirm the findings of Dr. Ardizzoni and colleagues, writing that "when you are hoping to cure NSCLC, cisplatin combinations are recommended."

However, they also caution against "overzealous use of cisplatin in patients with metastatic NSCLC in whom the drug may be poorly tolerated, such as those with substantial baseline renal impairment, hearing loss, peripheral neuropathy, or other serious medical conditions."

SOURCE:

J Natl Cancer Inst 2007;99:828-829,847-857

[Cindy RN]

I had the cisplatin with the camptosar for 8 months, I did not tell the Dr about the neuropathy until then. I had read back then it worked better than the carboplatin. My feet and fingers were so tingly and numb I had to say something.

He switched me to the carboplatin for the 9th month. I don't know if it being on it for so long that gave me a better outcome ???????

When it came back in 2003 he used the carboplatin and vp-16 and I had radiation because there was only one tumor.

Someday they will come up with the exact combo to cure it and maybe even (PLEASE) an actual vacine for cancer.

Cindy