© 2004 European Society for Medical Oncology
Original Article |
Addition of platinum compounds to a new agent in patients with advanced non-small-cell lung cancer: a literature based meta-analysis of randomised trials
1 Department of Medicine II, Okayama University Medical School, 2-5-1, Shikata-cho, Okayama, 700-8558; 2 Department of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1, Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan
* Correspondence to: Dr K. Hotta, Department of Medicine II, Okayama University Medical School, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan. Tel: +81-86-235-7227; Fax: +81-86-232-8226; Email: khotta{at}md.okayama-u.ac.jp
Background: Single new agents reportedly produce promising response and survival effects, but platinum-based doublets remain the standard chemotherapy for advanced non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the effectiveness of platinum for advanced NSCLC by carrying out a meta-analysis of trials that compared platinum-based doublets with single new agent therapy alone.
Methods: We carried out a literature search to identify trials, conducted between 1994 and 2003, comparing a doublet of platinum plus a new agent with a new agent alone in previously untreated patients with advanced NSCLC. Outcomes analysed were response, survival and toxicity.
Results: Eight trials encompassing 2374 patients were identified. Platinum-based doublets produced an approximately two-fold higher overall (complete and partial) response rate than the new agent alone [odds ratio = 2.32; 95% confidence interval (CI)=1.68–3.20]. Platinum-based doublet therapy was also associated with a 13% prolongation of survival (hazard ratio = 0.87; 95% CI = 0.80–0.94, P <0.001). Despite significant increases in the frequencies of various toxic effects in patients receiving platinum-based doublets, no significant difference in treatment-related mortality was observed.
Conclusion: This is the first published meta-analysis demonstrating the importance of combining platinum with single new agents in the treatment of advanced NSCLC.
Key words: doublets, non-small-cell lung cancer, platinum, single-agent therapy
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