Comparison of irinotecan/platinum versus etoposide/platinum chemotherapy for extensive-stage small cell lung cancer: A meta-analysis

Eur J Cancer Care (Engl). 2017 Nov;26(6). doi: 10.1111/ecc.12723. Epub 2017 Jul 13.

Abstract

This meta-analysis was performed to compare the effects and toxicities between irinotecan/platinum (IP) and etoposide/platinum (EP) regimens as the fist-line treatment of patients with extensive-stage small cell lung cancer (E-SCLC). A systematic search was made of MEDLINE, Cochrane, ISI Web of Science and SCOPUS databases. Randomised clinical trials on treatment of E-SCLC with the IP regimens, compared with EP regimens, were reviewed. Studies were pooled to hazard ratio (HR), relative risk (RR) and odds ratio (OR), with 95% confidence interval (CI). Eight trials (enrolling 2089 participants) met the inclusion criteria. Overall survival (OS) and 1-year survival rate were superior in the IP group (HR 0.83; 95% CI 0.75 to 0.91 and RR 1.19; 95% CI 1.06 to 1.34). Grades 3 and 4 anaemia, leukopenia, neutropenia, thrombocytopenia and febrile neutropenia were less frequent in the IP regimens than that in the EP regimens. And grades 3 and 4 nausea/vomiting, diarrheal, anorexia and fatigue were less frequent in the EP regimens. IP combination chemotherapy achieved a superior OS and 1-year survival rate, compared with EP doublets, in patients with E-SCLC.

Keywords: etoposide; irinotecan; meta-analysis; small cell lung carcinoma.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Anemia / chemically induced
  • Anemia / epidemiology
  • Anorexia / chemically induced
  • Anorexia / epidemiology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Carboplatin / administration & dosage
  • Chemotherapy-Induced Febrile Neutropenia / epidemiology
  • Cisplatin / administration & dosage
  • Diarrhea / chemically induced
  • Diarrhea / epidemiology
  • Etoposide / administration & dosage
  • Fatigue / chemically induced
  • Fatigue / epidemiology
  • Humans
  • Irinotecan
  • Leukopenia / chemically induced
  • Leukopenia / epidemiology
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Nausea / chemically induced
  • Nausea / epidemiology
  • Neoplasm Staging
  • Neutropenia / chemically induced
  • Neutropenia / epidemiology
  • Odds Ratio
  • Proportional Hazards Models
  • Small Cell Lung Carcinoma / drug therapy*
  • Small Cell Lung Carcinoma / pathology
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / epidemiology
  • Vomiting / chemically induced
  • Vomiting / epidemiology

Substances

  • Etoposide
  • Irinotecan
  • Carboplatin
  • Cisplatin
  • Camptothecin