What can platinum offer yet in the treatment of PS2 NSCLC patients? A systematic review and meta-analysis. Issue 3 (September 2015)

• Record Type: Journal Article
• Authors: Bronte, Giuseppe; Rolfo, Christian; Passiglia, Francesco; Rizzo, Sergio; Gil-Bazo, Ignacio; Fiorentino, Eugenio; Cajozzo, Massimo; Van Meerbeeck, Jan P.; Lequaglie, Cosimo; Santini, Daniele; Pauwels, Patrick; Russo, Antonio
• Is Part Of: Critical reviews in oncology/hematology. Volume 95:Issue 3(2015)
• Page Start: 306
• Page End: 317
• Publication Date: 2015-09
• Subjects: NSCLC -- Chemotherapy -- Performance status -- Platinum -- Doublet -- Single agent; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2015.03.010
• Languages: English
• ISSNs: 1040-8428

Abstract

Highlights: Comparison between platinum-based doublets and single-agents in NSCLC PS2 patients. Sistematic Review and Meta-analysis to estimate the effectiveness and safety of platinum-based doublets in NSCLC PS2 patients. Platinum-combination regimens are superior to single-agent both in terms of ORR and survival-rate with increase of severe hematological toxicities. A careful clinical selection among PS2 patients with NSCLC could help to identify those who could better tolerate platinum-based doublets, achieving a greater benefit from this treatment. Abstract: Background: Randomized phase III trials showed interesting, but conflicting results, regarding the treatment of NSCLC, PS2 population. This meta-analysis aims to review all randomized trials comparing platinum-based doublets and single-agents in NSCLC PS2 patients. Materials and methods: Data from all published randomized trials, comparing efficacy and safety of platinum-based doublets to single agents in untreated NSCLC, PS2 patients, were collected. Pooled ORs were calculated for the 1-year Survival-Rate (1y-SR), Overall Response Rate (ORR), and grade 3–4 (G3–4) hematologic toxicities. Results: Six eligible trials (741 patients) were selected. Pooled analysis showed a significant improvement in ORR (OR: 3.243; 95% CI: 1.883–5.583) and 1y-SR (OR: 1.743; 95% CI: 1.203–2.525) in favor of platinum-based doublets. G3–4 hematological toxicities were also more frequent in this group. Conclusion: This meta-analysis suggests that platinum-combination regimens are superior to singleagent both in terms of ORR and survival-rate with increase of severe hematological toxicities.