Cisplatin versus Carboplatin-Based Regimens for the Treatment of Patients with Metastatic Lung Cancer. An Analysis of Veterans Health Administration Data

Santana-Dávila, Rafael; Szabó, Anikó; Arce-Lara, Carlos; Williams, Christina D.; Kelley, Michael J.; Whittle, Jeff

doi:10.1097/jto.0000000000000146

Cited by 42 publications

(32 citation statements)

References 30 publications

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“…Although our analysis included veterans whose NSCLC was diagnosed and treated in the VHA, these data are likely to represent cancer outcomes more broadly. Previous studies have shown VHA lung cancer outcomes to be similar to both clinical trial 11 and private sector 9 outcomes. Indeed, in a study of Surveillance, Epidemiology, and End Results-Medicare data, 3-year OS after lobectomy for stage I NSCLC was 75% 12 versus 75.2% with VATS lobectomy and 68.1% with open lobectomy in this study.…”

Section: Discussionmentioning

confidence: 83%

Improved Survival of Stage I Non–Small Cell Lung Cancer: A VA Central Cancer Registry Analysis

Boyer

Williams

Harpole

et al. 2017

Journal of Thoracic Oncology

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Section: Discussionmentioning

confidence: 83%

Improved Survival of Stage I Non–Small Cell Lung Cancer: A VA Central Cancer Registry Analysis

Boyer

Williams

Harpole

et al. 2017

Journal of Thoracic Oncology

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“…Platinum-based doublets have traditionally been the standard of care for patients with metastatic NSCLC [6,7], although these treatments have been associated with toxicity and only limited survival benefit [8,9]. In addition to platinum-based chemotherapy, newer treatments are now available, including targeted therapy and immunotherapy, either alone or in combination with standard chemotherapy [6,7].…”

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confidence: 99%

Treatment Patterns and Overall Survival in Metastatic Non-Small-Cell Lung Cancer in a Real-World, US Setting

et al. 2019

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Aim: To conduct a retrospective analysis of electronic medical record data to understand real-world treatment patterns and overall survival (OS) in patients with metastatic non-small-cell lung cancer (NSCLC). Materials & methods: We included n = 9656 adults (≥18 years) with metastatic NSCLC and no prior therapy. Data from 1 January 2013 to 31 January 2017 were analyzed. Results: Carboplatin plus paclitaxel was the most common first-line therapy (18.6%), and nivolumab was the most common second- (31.0%) and third-line (38.4%) therapy; 26.7% of all patients were untreated. Median OS from initial metastatic diagnosis was 11.1 months (95% CI: 10.8–11.5). Second-line immunotherapy extended OS by over 3 months versus second-line chemotherapy. Conclusion: Platinum-based therapy was the most common first-line therapy, and immunotherapy was the most common second- and third-line therapy. Median OS of patients with metastatic NSCLC was <1 year.

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“…While in Europe, cisplatin‐based regimens remain the preferred choice in clinical practice, in the United States most patients are treated with carboplatin‐based regimens . A retrospective analysis of real life data showed no survival benefit in using cisplatin rather carboplatin combination therapy . Even if the use of cisplatin seems to be less prudent in “unfit” patients, a randomized phase III trial evaluated a modified cisplatin and gemcitabine schedule compared to gemcitabine alone in PS 2 patients and showed significantly longer median PFS and higher objective response rate (ORR) in favor of the doublet, without significantly different toxicity .…”

Section: Introductionmentioning

confidence: 99%

“…25 A retrospective analysis of real life data showed no survival benefit in using cisplatin rather carboplatin combination therapy. 26 Even if the use of cisplatin seems to be less prudent in "unfit" patients, a randomized phase III trial evaluated a modified cisplatin and gemcitabine schedule compared to gemcitabine alone in PS 2 patients and showed significantly longer median PFS and higher objective response rate (ORR) in favor of the doublet, without significantly different toxicity. 27 Two ongoing Italian randomized trials were designed to compare cisplatin-based combinations to the relative single-agent using groups aged > 70 years and patients with PS 0-1.…”

Section: Introductionmentioning

confidence: 99%

Multicentric retrospective analysis of platinum‐pemetrexed regimens as first‐line therapy in non‐squamous non‐small cell lung cancer patients: A “snapshot” from clinical practice

et al. 2017

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BackgroundThe major challenge for treating non‐squamous (non‐Sq) non‐small cell lung cancer (NSCLC) patients without actionable biomarkers is the actual selection of proper treatment, weighing expected clinical outcomes and safety profile.MethodsConsecutive non‐Sq NSCLC patients were treated with platinum‐pemetrexed (PP) doublets in clinical practice. Subgroup analyses were conducted in patients treated with standard (s)PP and modified (m)PP doublets (because of age, performance status, and/or comorbidities) and in patients treated with cisplatin‐based and carboplatin‐based PP doublets. Activity, efficacy, safety, and toxicities were evaluated.ResultsFrom November 2009 to April 2017, 111 patients were treated: 87 (78.4%) with sPP and 24 (21.6%) with mPP; 76 (68.5%) with cisplatin‐based and 35 (31.5%) with carboplatin‐based regimens. The objective response rate (ORR), median progression‐free survival (PFS), and median overall survival (OS) were 49.0%, 7, and 13 months in the entire patient population, respectively. We found no significant differences in ORR, median PFS, and median OS between sPP and mPP. Cisplatin‐based PP showed higher ORR (53.7%) versus carboplatin‐based PP (38.7%) and longer PFS (7 vs. 6 months; P = 0.028) and OS (18 vs. 11 months; P = 0.006). We confirm that carboplatin has a better toxicity profile than cisplatin. The received dose‐intensities were ~80% of standard full doses.ConclusionsAccurate management allowed us to treat the majority of advanced non‐Sq NSCLC patients with PP combination therapy without significant differences in ORR, median PFS, and median OS. Even considering the selection bias, our data seems to confirm the greater effectiveness of cisplatin‐based over carboplatin‐based regimens.

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Cisplatin versus Carboplatin-Based Regimens for the Treatment of Patients with Metastatic Lung Cancer. An Analysis of Veterans Health Administration Data

Cited by 42 publications

References 30 publications

Improved Survival of Stage I Non–Small Cell Lung Cancer: A VA Central Cancer Registry Analysis

Improved Survival of Stage I Non–Small Cell Lung Cancer: A VA Central Cancer Registry Analysis

Treatment Patterns and Overall Survival in Metastatic Non-Small-Cell Lung Cancer in a Real-World, US Setting

Multicentric retrospective analysis of platinum‐pemetrexed regimens as first‐line therapy in non‐squamous non‐small cell lung cancer patients: A “snapshot” from clinical practice

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