Safety of irinotecan/cisplatin versus etoposide/cisplatin for patients with extensive-stage small-cell lung cancer: a metaanalysis.
OBJECTIVE
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).


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).


CONCLUSIONS
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.
Jiang
Lei
L
Evidence Based Medicine Center of Lanzhou University, Lanzhou City, Gansu Province, China.
Yang
Ke-Hu
KH
Mi
Deng-Hai
DH
Liu
Ya-Li
YL
Tian
Jin-Hui
JH
Ma
Bin
B
Tan
Ji-Ying
JY
Bai
Zheng-Gang
ZG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D003967:Diarrhea / Q000139:chemically induced; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D014839:Vomiting / Q000139:chemically induced
D005047:Etoposide; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin