Researchers affiliated with the Cochrane Library have reported that chemotherapy regimens that do not contain platinum agents (Platinol and Paraplatin) appear to be just as effective as regimens that do contain platinum agents in the treatment of small cell lung cancer. These results were recently published in the Cochrane Database of Systematic Reviews.

Small cell lung cancer (SCLC) accounts for approximately one-quarter of all lung cancers. SCLC is a very fast growing type of lung cancer, often spreading to distant sites in the body very quickly. Chemotherapy regimens that include a platinum agent have been the standard therapeutic approach for SCLC; however, these regimens are associated with extensive side effects. As such, researchers continue to evaluate novel chemotherapy regimens in the treatment of this disease, with the ultimate goal of improving survival and/or quality of life.

Researchers from Australia recently conducted a large study that included evaluation of data from 29 clinical trials and over 5,500 patients with SCLC. Outcomes among patients treated with either platinum regimens or non-platinum regimens were compared.

Overall survival was similar at 6, 12 and 24 months between patients treated with platinum-containing regimens compared to those treated with non-platinum-containing regimens. Overall response rates were also similar between patients treated with either platinum or non-platinum-containing chemotherapy regimens. Complete responses, however, were greater among patients treated with platinum-containing regimens. Side effects such as nausea and vomiting and low levels of blood cells occurred more frequently among patients treated with platinum agents.

The researchers concluded that non-platinum containing regimens result in similar survival with fewer severe side effects than the standard platinum-containing regimens for the treatment of SCLC.

Comments: The current standard of care for patients with SCLC is VePesid®/Platinol®. Whether or not the findings in this review change current recommendations remains to be determined. However, for patients receiving palliative treatment, it is reassuring to know that platinum alternatives are equally effective.

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Reference: Amarasena I, et al. Platinum versus non-platinum chemotherapy regimens for small cell lung cancer (Review). Cochrane Database Syst Rev. 2008; DOI: 10.1002/14651858.CD006849.pub2.