Randomized comparison of lobaplatin plus etoposide and cisplatin plus etoposide chemotherapy in patients with extensive-stage small cell lung cancer

Objective

To compare the efficacy and safety of Lobaplatin plus Etoposide (EL) and Cisplatin plus Etoposide (EP) regimens in chemonaive with extensive-stage small-cell lung cancer (SCLC).

Methods

Between July 2010 and July 2011, a total of 62 patients with extensive-stage small-cell lung cancer who received initial treatment in our hospital and 309 hospital of PLA. 31 patients were randomly assigned to the EL Group: Lobaplatin was given intravenously at a dose of 30 mg/m² on day 1 and Etoposide 100 mg/m² on days 1 to 3 of 21-day cycles for a maximum of six cycles. Another 31 patients were assigned to the EP Group: Cisplatin was given intravenously at a dose of 75 mg/m² on day 1 and Etoposide 100 mg/m² on days 1 to 3 of 21-day cycles for a maximum of six cycles. We evaluated the efficacy, overall response rate (ORR), disease control rate (DCR), the progression-free survival (PFS) and toxicity between the patients of the two groups.

Results

All 62 patients were eligible. In the EL group, 2 (6.5%) patients had complete response, 20 (64.5%) patients had partial response, 5 (16.1%) patients had stable disease and 4 (12.9%) patients had progress disease. In the EP group, 2 (6.5%) patients had complete response, 22 (70.9%) patients had partial response, 4 (12.9%) patients had stable disease and 3 (9.7%) patients had progress disease. The ORR of EL and EP group were 70.9% and 77.4%, respectively, showing no significant difference (P = 0.562). The DCR of both groups were 87% and 90%, respectively, showing no significant difference (P = 0.688). Median PFS of patients with EL and EP regimens were 5.5 months and 5 months, respectively, showing no significant difference (P = 0.637). Adverse events were observed in all 62 patients. Grade 1 to 4 anemia was higher in the EP group than in EL group, showing significant difference (P = 0.02). Grade 3 and 4 thrombocytopenia was seen in 4 patients (12.9%) in EL group and 1 patient (3.2%) in EP group. Although one patient had platelet transfusion owing to Grade 4 thrombocytopenia in EL group, no significant difference (P = 0.637) were shown. The incidence of nausea/vomiting was higher in the EP group than in the EL group (96.7% vs 51.6%, P = 0.00).

Conclusion

The EL regimen is an effective and low-toxicity chemotherapy and no inferior to EP regimen in treatment response, therefore, EL regimen maybe is a good choice for patients with extensive-stage SCLC.