Cisplatin versus carboplatin in combination with third-generation drugs for advanced non-small cell lung cancer

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dc.contributor.author Castria, TB
dc.contributor.author Silva, Edina Mariko Koga da [UNIFESP]
dc.contributor.author Góis, Aécio Flávio Teixeira de [UNIFESP]
dc.contributor.author Riera, Rachel [UNIFESP]
dc.date.accessioned 2016-01-24T14:28:11Z
dc.date.available 2016-01-24T14:28:11Z
dc.date.issued 2013-01-01
dc.identifier http://dx.doi.org/10.1002/14651858.CD009256.pub2
dc.identifier.citation Cochrane Database of Systematic Reviews. Hoboken: Wiley-Blackwell, n. 8, 58 p., 2013.
dc.identifier.issn 1469-493X
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/35637
dc.description.abstract BackgroundAn estimated 220,000 new cases of non-small cell lung cancer (NSCLC) and 160,000 deaths are expected to occur in the US in 2013, representing about 28% of cancer-related mortality. Approximately 75% of these people will have locally advanced or metastatic disease and will be treated in a palliative setting. Platinum-based combination chemotherapy has benefits in terms of survival and symptom control when compared with best supportive care.ObjectivesTo assess the efficacy and safety of carboplatin-based chemotherapy when compared with cisplatin-based chemotherapy, both in combination with a third-generation drug, in people with advanced NSCLC. To compare quality of life in people with advanced NSCLC receiving chemotherapy with cisplatin and carboplatin combined with a third-generation drug.Search methodsWe searched the following electronic databases: MEDLINE (via PubMed) (1966 to 6 March 2013), EMBASE (via Ovid) (1974 to 6 March 2013), Cochrane Central Register of Controlled Trials (CENTRAL; Issue 2, 2013), and LILACS (1982 to 6 March 2013). in addition, we handsearched the proceedings of the American Society of Clinical Oncology Meetings (January 1990 to March 2013), reference lists from relevant resources and the Clinical Trial.gov database.Selection criteriaRandomised clinical trials comparing regimens with carboplatin or cisplatin combined with a third-generation drug in people with locally advanced or metastatic NSCLC. We accepted any regimen and number of cycles that included these drugs, since there is no widely accepted standard regimen.Data collection and analysisTwo review authors independently assessed search results and a third review author resolved any disagreements. We analysed the following endpoints: overall survival, one-year survival, quality of life, toxicity and response rate.Main resultsWe included 10 trials with 5017 people, 3973 of whom were available for meta-analysis. There was no difference between carboplatin-based and cisplatin-based chemotherapy in overall survival (hazard ratio (HR) 1.00; 95% confidence interval (CI) 0.51 to 1.97, I-2 = 0%) and one-year survival rate (risk ratio (RR) 0.98; 95% CI 0.88 to 1.09, I-2 = 24%). Cisplatin had higher response rates when we performed an overall analysis (RR 0.88; 95% CI 0.79 to 0.99, I-2 = 3%), but trials using paclitaxel or gemcitabine plus a platin in both arms had equivalent response rates (paclitaxel: RR 0.89; 95% CI 0.74 to 1.07, I-2 = 0%; gemcitabine: RR 0.92; 95% CI 0.73 to 1.16, I-2 = 34%). Cisplatin caused more nausea or vomiting, or both (RR 0.46; 95% CI 0.32 to 0.67, I-2 = 53%) and carboplatin caused more thrombocytopenia (RR 2.00; 95% CI 1.37 to 2.91, I-2 = 21%) and neurotoxicity (RR 1.55; 95% CI 1.06 to 2.27, I-2 = 0%). There was no difference in the incidence of grade III/IV anaemia (RR 1.06; 95% CI 0.79 to 1.43, I-2 = 20%), neutropenia (RR 0.96; 95% CI 0.85 to 1.08, I-2 = 49%), alopecia (RR 1.11; 95% CI 0.73 to 1.68, I-2 = 0%) or renal toxicity (RR 0.52; 95% CI 0.19 to 1.45, I-2 = 3%). Two trials performed a quality of life analysis; however, they used different methods of measurement so we could not perform a meta-analysis.Authors' conclusionsThe initial treatment of people with advanced NSCLC is palliative, and carboplatin can be a treatment option. It has a similar effect on survival but a different toxicity profile when compared with cisplatin. Therefore, the choice of the platin compound should take into account the expected toxicity profile and the person's comorbidities. in addition, when used with either paclitaxel or gemcitabine, the drugs had an equivalent response rate. en
dc.description.sponsorship Brazilian Cochrane Center, Brazil
dc.format.extent 58
dc.language.iso eng
dc.publisher Wiley-Blackwell
dc.relation.ispartof Cochrane Database of Systematic Reviews
dc.rights Acesso aberto
dc.title Cisplatin versus carboplatin in combination with third-generation drugs for advanced non-small cell lung cancer en
dc.type Resenha
dc.rights.license http://olabout.wiley.com/WileyCDA/Section/id-406071.html
dc.contributor.institution Universidade de São Paulo (USP)
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Ctr Estudos Med Baseada Evidencias & Avaliacao Te
dc.description.affiliation FMUSP, ICESP, BR-01246000 São Paulo, Brazil
dc.description.affiliation Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliation Universidade Federal de São Paulo, Brazilian Cochrane Ctr, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliation Ctr Estudos Med Baseada Evidencias & Avaliacao Te, Brazilian Cochrane Ctr, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Brazilian Cochrane Ctr, Escola Paulista Med, São Paulo, Brazil
dc.identifier.doi 10.1002/14651858.CD009256.pub2
dc.description.source Web of Science
dc.identifier.wos WOS:000323928900027



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