Irinotecan plus cisplatin compared with etoposide plus cisplatin in patients with previously untreated extensive-stage small cell lung cancer: A meta-analysis

• Published in: Journal of cancer research and therapeutics Vol. 14; no. 12; pp. 1076 - 1083
• Main Authors: Liu, Zi-Li, Wang, Bin, Liu, Ji-Zhu, Liu, Wei-Wei
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.12.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Anemia; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer therapies; Chemotherapy; Cisplatin; Cisplatin - therapeutic use; Comparative analysis; Diarrhea; Diarrhea - chemically induced; Diarrhea - epidemiology; Disease control; Dosage and administration; Drug therapy; Etoposide; Etoposide - therapeutic use; Hematologic Diseases - chemically induced; Hematologic Diseases - epidemiology; Hematology; Humans; Incidence; Infrastructure (Economics); Irinotecan; Irinotecan - therapeutic use; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lymphatic system; Meta-analysis; Metabolism; Nausea - chemically induced; Nausea - epidemiology; Neoplasm Staging; Neutropenia; Patients; Quality; Randomized Controlled Trials as Topic; Response rates; Small cell lung cancer; Small Cell Lung Carcinoma - drug therapy; Small Cell Lung Carcinoma - mortality; Small Cell Lung Carcinoma - pathology; Studies; Survival Rate; Treatment Outcome; Vomiting - chemically induced; Vomiting - epidemiology; China; meta-analysis; etoposide; irinotecan; small cell lung cancer; Cisplatin; randomized controlled trial
• ISSN: 0973-1482; 1998-4138
• DOI: 10.4103/0973-1482.199387

Objective: To systematically review the effect and safety of irinotecan plus cisplatin (IP) compared with etoposide plus cisplatin (EP) in patients with previously untreated extensive-stage small cell lung cancer (E-SCLC). Materials and Methods: Databases including PubMed, The Cochrane Library, EMBASE, China National Knowledge Infrastructure, VIP, and WanFang Data were searched for the randomized controlled trials (RCTs) about IP compared with EP in patients with previously untreated E-SCLC from the establishment to June 2016. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software (Cochrane Collaboration, Oxford, UK). Results: A total of 12 RCTs involving 2030 patients were finally included. Meta-analysis showed that compared with EP regimen, IP regimen significantly improved the 1- and 2-year survival rates of the patients with previously untreated E-SCLC (risk ratio [RR] = 1.16, 95% confidence interval [CI] [1.03-1.31], P = 0.02; RR = 1.79, 95% CI [1.22-2.61], P = 0.003, respectively). However, there was no significant difference between IP regimen and EP regimen in the objective response rate (ORR) (RR = 1.07, 95% CI [0.99-1.15], P = 0.10) and disease control rate (DCR) (RR = 1.03, 95% CI [0.96-1.10], P = 0.38). The incidence of Grade 3/4 leukopenia, neutropenia, anemia, and thrombocytopenia of IP regimen was sigificantly lower than EP regimen (all P < 0.05), the incidence of Grade 3/4 nausea/vomiting and diarrhea of IP regimen was sigificantly higher than EP regimen (all P < 0.05). Conclusion: IP regimen significantly improves the 1- and 2-year survival rates, but not significantly improves the ORR and DCR, compared with EP regimen in patients with previously untreated E-SCLC. IP regimen has less Grade 3 or 4 hematological adverse events. IP regimen is an alternative of EP regimen in patients with previously untreated E-SCLC.