Researchers from the United Kingdom have reported that a regimen of Gemzar® (gemcitabine) and Paraplatin® (carboplatin) is as effective palliation as standard Platinol® (cisplatin) and VePesid® (etoposide) for patients with poor-risk small cell lung cancer (SCLC) but with less toxicity. The details of this study appeared in an early online publication in Thorax on September 11, 2008.[1]

Small cell lung cancer 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. The standard regimen for treating patients with SCLC is Platinol and VePesid.

The current trial involved several medical centers in the United Kingdom and enrolled 241 patients with untreated extensive SCLC. Patients were randomly allocated to receive Gemzar and Paraplatin or standard Platinol and VePesid. The following table summarizes the main findings of this trial:

Table 1: Gemzar-Paraplatin Versus Platinol-VePesid in Extensive SCLC

These authors reported that grade 3-4 myelosuppression was greater in the Gemzar-Paraplatin group than in the Platinol-VePesid group. Other non-hematologic toxicities, such as nausea and hair loss, were also greater in the Platinol-VePesid group. Patients in the Gemzar-Paraplatin group received 89% of their chemotherapy as outpatients compared with 66% for the Platinol-VePesid group. The most common complaints of patients in the Platinol-VePesid group were hair loss and impaired cognitive functioning. These authors concluded: “[Gemzar-Paraplatin] is as effective as [Platinol-VePesid] in terms of overall survival and progression-free survival and has a toxicity profile more acceptable to patients.”

Comments: These data suggest that the Gemzar-Paraplatin regimen is less toxic and as effective as standard Platinol-VePesid. Unfortunately, the outcomes of patients with SCLC appear to be little improved with any new form of therapy.

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