PMID- 34876060 OWN - NLM STAT- MEDLINE DCOM- 20220223 LR - 20220223 IS - 1471-2407 (Electronic) IS - 1471-2407 (Linking) VI - 21 IP - 1 DP - 2021 Dec 7 TI - Carboplatin versus cisplatin in combination with etoposide in the first-line treatment of small cell lung cancer: a pooled analysis. PG - 1308 LID - 10.1186/s12885-021-09034-6 [doi] LID - 1308 AB - BACKGROUND: Extensive-stage small cell lung cancer (ES-SCLC) is an aggressive disease with poor survival, and platinum-etoposide chemotherapy is indicated as the mainstay of treatment. In this study, we compared the efficacy and safety between the cisplatin plus etoposide (EP) and carboplatin plus etoposide (EC) regimens. METHODS: A total of 1305 patients with previously untreated ES-SCLC were included in this study. Data from five trials were collected from the public database Project Data Sphere. Survival analysis and adverse events (AEs) analysis were conducted. RESULTS: Of the 1305 patients, 800 received the EC regimen whereas 505 received the EP regimen as their front-line treatment. Overall, the median progression-free survival (PFS) and the median overall survival (OS) were 172 and 289 days, respectively. The EP and EC treatment groups did not have significantly different PFS or OS. After adjusting for age, sex, body mass index (BMI) and Eastern Cooperative Oncology Group (ECOG) performance status (PS), the EP regimen was independently associated with better PFS (hazard ratio [HR] = 0.76, 95% CI = 0.63-0.92, p = 0.0041) and OS (HR = 0.79, 95% CI = 0.64-0.97, p = 0.0220) among patients who were overweight and obese (BMI >/= 25 kg/m(2)). In the safety analysis, patients who received the EC treatment experienced significantly more grade >/= 3 AEs (n = 599, 74.9%) than those who received the EP treatment (n = 337, 66.7%; p = 0.002). Furthermore, the EC regimen was associated with a higher risk of grade 3-4 neutropaenia (p = 0.001), thrombocytopaenia (p < 0.001) and hyponatraemia (p = 0.036), whereas the EP regimen was associated with a higher risk of grade 3-4 vomiting (p = 0.021). CONCLUSIONS: In summary, this study presented the efficacy and safety of the EC and EP regimens in patients with ES-SCLC in the first-line setting. Patients who are overweight and obese benefit more from the EP regimen than EC regimen. Approaches to define the optimal chemotherapy regimen in different BMI subgroups are needed. CI - (c) 2021. The Author(s). FAU - Jiang, Shiyu AU - Jiang S AD - Department of Medical Oncology, Fudan University Shanghai Cancer Center; Institute of Thoracic Oncology, Fudan University, 270 Dongan Rd, Shanghai, 200032, China. AD - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. FAU - Huang, Liling AU - Huang L AD - Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100021, China. FAU - Zhen, Hongnan AU - Zhen H AD - Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Jin, Peijie AU - Jin P AD - Philips Research, Shanghai, 200032, China. FAU - Wang, Jing AU - Wang J AD - Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. nancy1248@sina.com. AD - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. nancy1248@sina.com. FAU - Hu, Zhihuang AU - Hu Z AD - Department of Medical Oncology, Fudan University Shanghai Cancer Center; Institute of Thoracic Oncology, Fudan University, 270 Dongan Rd, Shanghai, 200032, China. zhihuanghu@hotmail.com. AD - Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. zhihuanghu@hotmail.com. LA - eng PT - Clinical Trial PT - Journal Article DEP - 20211207 PL - England TA - BMC Cancer JT - BMC cancer JID - 100967800 RN - 6PLQ3CP4P3 (Etoposide) RN - BG3F62OND5 (Carboplatin) RN - Q20Q21Q62J (Cisplatin) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/*administration & dosage MH - Carboplatin/*administration & dosage MH - Cisplatin/*administration & dosage MH - Etoposide/*administration & dosage MH - Female MH - Humans MH - Lung Neoplasms/*drug therapy/mortality MH - Male MH - Middle Aged MH - Progression-Free Survival MH - Small Cell Lung Carcinoma/*drug therapy/mortality MH - Survival Rate MH - Treatment Outcome PMC - PMC8650295 OTO - NOTNLM OT - Adverse events OT - Extensive-stage OT - Small cell lung cancer OT - Treatment COIS- The authors have no conflicts of interest to declare. EDAT- 2021/12/09 06:00 MHDA- 2022/02/24 06:00 PMCR- 2021/12/07 CRDT- 2021/12/08 05:34 PHST- 2021/09/12 00:00 [received] PHST- 2021/11/18 00:00 [accepted] PHST- 2021/12/08 05:34 [entrez] PHST- 2021/12/09 06:00 [pubmed] PHST- 2022/02/24 06:00 [medline] PHST- 2021/12/07 00:00 [pmc-release] AID - 10.1186/s12885-021-09034-6 [pii] AID - 9034 [pii] AID - 10.1186/s12885-021-09034-6 [doi] PST - epublish SO - BMC Cancer. 2021 Dec 7;21(1):1308. doi: 10.1186/s12885-021-09034-6.