The best platinum regimens for chemo-naive incurable non-small cell lung cancer: network meta-analysis

Sci Rep. 2017 Oct 13;7(1):13185. doi: 10.1038/s41598-017-13724-2.

Abstract

Platinum regimens still play a key role in chemotherapy for incurable non-small cell lung cancer (NSCLC). Although guidelines list many platina regimens, the best regimens have not yet clarified. Electronic searches were carried out during November 26th-28th, 2016. We included individually randomized trials comparing two or more platinum regimes for incurable chemo-naive NSCLC published in English full papers. The platinum doublets should be either Cisplatin (CDDP), Carboplatin (CBDCA), or Nedaplatin (CDGP) plus one of the third-generation agents. The platinum triplet should be the doublet plus bevacizumab (BEV). The data were independently extracted and cross-checked by two investigators. We did not observed heterogeneity (whole network level Q = 28.9, df = 34, P = 0.717) among 59 pairwise comparisons from 45 studies with 16141 cases for the primary outcome, hazard ratio for overall survival (HRos). Using CBDCA + Paclitaxel (PTX) + BEV as a common comparator, CDGP + Docetaxel (DTX) (HRos = 0.98, 95%CI: 0.75-1.29, P = 0.884), CDDP + Tegafur gimeracil oteracil (S1) (HRos = 1.23, 95%CI: 0.96-1.57, P = 0.099), CBDCA + S1 (HRos = 1.23, 95%CI: 0.99-1.53, P = 0.062), and CDGP + Gemcitabine (GEM) (HRos = 1.24, 95%CI: 0.71-2.17, P = 0.45) did not have significantly poorer HRos. We suggest that these regimens as acceptable first-choice regimens.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Bevacizumab / therapeutic use
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Cisplatin / therapeutic use
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Docetaxel / therapeutic use
  • Gemcitabine
  • Humans
  • Lung Neoplasms / drug therapy*
  • Network Meta-Analysis
  • Paclitaxel / therapeutic use
  • Platinum / therapeutic use*

Substances

  • Antineoplastic Agents
  • Deoxycytidine
  • Docetaxel
  • Bevacizumab
  • Platinum
  • Paclitaxel
  • Cisplatin
  • Gemcitabine