What can platinum offer yet in the treatment of PS2 NSCLC patients? A systematic review and meta-analysis.
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.


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.


CONCLUSIONS
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.
Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy.
Giuseppe
G
Bronte
Phase I-Early Clinical Trials Unit, Oncology Department and Multidisciplinary Oncology Center Antwerp (MOCA) Antwerp University Hospital, Edegem, Belgium. Electronic address: christian.rolfo@uza.be.
Christian
C
Rolfo
Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy.
Francesco
F
Passiglia
Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy.
Sergio
S
Rizzo
Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain.
Ignacio
I
Gil-Bazo
Department of Surgical, Oncological and Oral Sciences, Section of Surgical Oncology, University of Palermo, Palermo, Italy.
Eugenio
E
Fiorentino
Department of Surgical, Oncological and Oral Sciences, Section of Thoracic Surgery, University of Palermo, Palermo, Italy.
Massimo
M
Cajozzo
Thoracic Oncology, Multidisciplinary Oncology Center Antwerp (MOCA) Antwerp University Hospital, Edegem, Belgium.
Jan P
JP
Van Meerbeeck
Department of Thoracic Surgery, I.R.C.C.S.-C.R.O.B. Basilicata Regional Cancer Institute, Rionero in Vulture, Italy.
Cosimo
C
Lequaglie
Department of Medical Oncology, University Campus Bio-Medico, Rome, Italy.
Daniele
D
Santini
Molecular Pathology Unit, Pathology Department and Multidisciplinary Oncology Center Antwerp (MOCA) Antwerp University Hospital, Edegem, Belgium.
Patrick
P
Pauwels
Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy.
Antonio
A
Russo
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D010984:Platinum / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
D010984:Platinum
Chemotherapy; Doublet; NSCLC; Performance status; Platinum; Single agent