Safety of Irinotecan/Cisplatin Versus Etoposide/Cisplatin for Patients with Extensive-Stage Small-Cell Lung Cancer: A Metaanalysis

• Published in: Clinical lung cancer 2007-09, Vol.8 (8), p.497-501
• Main Authors: Jiang, Lei, Yang, Ke-Hu, Mi, Deng-hai, Liu, Ya-Li, Tian, Jin-Hui, Ma, Bin, Tan, Ji-Ying, Bai, Zheng-Gang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anemia; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Camptothecin - administration & dosage; Camptothecin - analogs & derivatives; Carcinoma, Small Cell - drug therapy; Cisplatin - administration & dosage; Diarrhea; Diarrhea - chemically induced; Etoposide - administration & dosage; Female; Hematologic Diseases - chemically induced; Hematology, Oncology and Palliative Medicine; Humans; Leukopenia; Lung Neoplasms - drug therapy; Male; Middle Aged; Nausea; Nausea - chemically induced; Neoplasm Staging; Neutropenia; Pulmonary/Respiratory; Randomized Controlled Trials as Topic; Thrombocytopenia; Toxicity; Vomiting; Vomiting - chemically induced
• ISSN: 1525-7304; 1938-0690
• DOI: 10.3816/CLC.2007.n.035

Abstract PURPOSE The objective of this study was to evaluate the safety of patients with extensive small-cell lung cancer treated with irinotecan/cisplatin (IP) versus etoposide/cisplatin (EP). PATIENTS AND METHODS This is a metaanalysis of a randomized controlled trial. The main outcome measures for safety were grade 3/4 leukopenia, grade 3 anemia, grade 3/4 thrombocytopenia, grade 3/4 neutropenia, grade 3 vomiting/nausea, grade 3/4 diarrhea, and infection. RESULTS Three randomized controlled trials totaling 535 patients were included. Metaanalysis results are as follows: fewer patients receiving IP experienced grade 3/4 leukopenia (response rate [RR], 0.44; 95% confidence interval [CI], 0.29-0.67), grade 3 anemia (RR, 0.65; 95% CI, 0.43-0.99), and grade 3/4 thrombocytopenia (RR, 0.23; 95% CI, 0.12-0.42), compared with patients receiving EP. But more patients experienced grade 3 vomiting or nausea (RR, 2.27; 95% CI, 1.37-3.37) and grade 3/4 diarrhea (RR, 21.66; 95% CI, 4.87-96.2). There was no significant difference between the 2 groups with regard to infection (RR, 0.75; 95% CI, 0.54-1.04). CONCLUSION Current clinical studies might confirm that fewer patients receiving IP experienced grade 3/4 leukopenia, grade 3 anemia, grade 3/4 thrombocytopenia, and grade 3/4 neutropenia, compared with patients receiving EP, but more experienced grade 3 vomiting/nausea and grade 3/4 diarrhea. There was no significant difference between the group receiving IP and the group receiving EP with regard to infection. Although there is convincing evidence to confirm the results mentioned herein, they still need to be confirmed by large-sample, multicenter, randomized, controlled trials.