The gist: Recent research comparing two drug combinations for stage III non-small cell lung cancer (NSCLC) suggests that the drug combo etoposide/cisplatin does not help people live longer than carboplatin/paclitaxel does, and it also may result in more side effects. Both drug combos are taken alongside radiation treatment.
“In an analysis of Veterans Health Administration data reported in the Journal of Clinical Oncology, Santana-Davila et al found that etoposide/cisplatin resulted in no overall survival difference but greater morbidity compared with carboplatin/paclitaxel used concurrently with radiotherapy in patients with stage III non–small cell lung cancer (NSCLC).
“The analysis involved 1,842 patients treated with etoposide/cisplatin (n = 499) or carboplatin/paclitaxel (n = 1,343) between 2001 and 2010. In a Cox proportional hazard model, age (hazard ratio [HR] = 1.08, P = .0258), percentage weight loss (HR = 1.04, P < .0001), baseline anemia (HR = 1.19, P = .0064), hypoalbuminemia (HR = 1.29; 95% confidence interval [CI] = 1.14–1.46; P < .001), and treatment era (HR = 0.89 for 2005-2007 and 0.83 for 2008-2010 vs 2001-2004, P = .028) were independently associated with overall survival, whereas chemotherapy regimen (median overall survival = 17.3 months for etoposide/cisplatin vs 14.6 months for carboplatin/paclitaxel, HR = 0.97, P = .6327), stage (HR = 1.08, P = .185, for IIIB vs IIIA), and National Cancer Institute combined index score (HR = 1.17, P = .0503) were not associated with survival…
“The investigators concluded: ‘After accounting for prognostic variables, patients treated with [etoposide/cisplatin vs carboplatin/paclitaxel] had similar overall survival, but [etoposide/cisplatin] was associated with increased morbidity.’ ”